NPIMap

Organization Active NPI

Community Health Center of Branch County

Doing business as CHC Oriole Connect

  • Pediatric Adolescent Medicine Physician
  • Quincy, MI
National Provider Identifier
1851687107
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
COMMUNITY HEALTH CENTER OF BRANCH COUNTY
Doing business as
CHC Oriole Connect
Practice address
18 Colfax St
Quincy, MI 49082-1139
Phone
(517) 279-5297
NPI assigned
Jun 24, 2011
Last updated
Jul 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Randall Degroot
Title
President/Ceo
Phone
(517) 279-5489

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X Primary

Addresses

Primary practice location

18 Colfax St
Quincy, MI 49082-1139

Mailing address

274 E Chicago St
Coldwater, MI 49036-2041
Phone (517) 279-5400

Other names 1

  • CHC Oriole Connect Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000671 MI Part B Supplier - Clinic/Group Practice 9335037514 Receives reassigned benefits from 162 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coldwater, MI; Union City, MI; Quincy, MI; Litchfield, MI; Bronson, MI

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Community HLTH CNTR19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

18 Colfax St
Quincy, MI 49082
Phone (517) 279-5275

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1851687107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 E CHICAGO ST",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490362041",
            "telephone_number": "517-279-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 COLFAX ST",
            "city": "QUINCY",
            "state": "MI",
            "postal_code": "490821139",
            "telephone_number": "517-279-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF BRANCH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "DEGROOT",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "517-279-5489",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHC Oriole Connect",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.