NPIMap

Organization Active NPI

Marlette Regional Hospital

  • Family Medicine Physician
  • North Branch, MI
National Provider Identifier
1871797571
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARLETTE REGIONAL HOSPITAL
Practice address
4000 Huron St
North Branch, MI 48461
Phone
(810) 688-3048
Fax
(877) 848-0921
NPI assigned
Jun 14, 2007
Last updated
Jul 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Authorized official

Name
Mr. Daniel G Babcock
Title
Ceo
Phone
(989) 635-4002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4000 Huron St
North Branch, MI 48461

Mailing address

2770 Main St
Marlette, MI 48453-1141
Phone (989) 635-4000

Other identifiers 1

IdentifierTypeStateIssuer
0D410160OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070714000020 MI Part B Supplier - Clinic/Group Practice 3971408121 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Marlette, MI; North Branch, MI

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Marlette Comm Hosp ER P17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1871797571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST",
            "city": "MARLETTE",
            "state": "MI",
            "postal_code": "484531141",
            "telephone_number": "989-635-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HURON ST",
            "city": "NORTH BRANCH",
            "state": "MI",
            "postal_code": "48461",
            "telephone_number": "810-688-3048",
            "fax_number": "877-848-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLETTE REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "BABCOCK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "989-635-4002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0D410160",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Branch, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; 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.