Promedica Central Corporation of Michigan

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

PROMEDICA CENTRAL CORPORATION OF MICHIGAN

Practice address

324 E Maumee St
Adrian, MI 49221-2961

Phone

(517) 265-3307

NPI assigned

Feb 12, 2019

Organization subpart

Yes

Parent organization

PROMEDICA PHYSICIAN GROUP INCAs reported in NPPES

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

Authorized official

Name

Kristin Knueven

Title

Delegated Official

Phone

(567) 585-1969

Specialties & licenses 1

Addresses

Tax ID family

Promedica Corp of Mi2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Promedica Central Corporation of Michigan

  • Rural Health Clinic/Center
  • Tecumseh, MI
  • NPI 1427609312
  NPD tax ID

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1861958076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "567-585-1969",
            "fax_number": "419-824-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E MAUMEE ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212961",
            "telephone_number": "517-265-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDICA CENTRAL CORPORATION OF MICHIGAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROMEDICA PHYSICIAN GROUP INC",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "KNUEVEN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "567-585-1969"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Chiropractic PLLC
• Primetime Chiropractic PLLC
• Kaitlyn Nicole Probelski
• Shelly Elizabeth Proffitt, CHW
• Tesha Proffitt
• Promedica Central Physicians
• Promedica Continuing Care Services Corp
• Promedica Northwest Ohio Cardiology Consultants, LLC
• Promedica of Adrian Mi, LLC
• Whitney Alysse Puckey, LLPC

• Podiatrist in Adrian, MI
• Providers in Adrian, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.