NPIMap

Organization Active NPI

Prescott Clinic P.C.

  • Rural Health Clinic/Center
  • Prescott, MI
National Provider Identifier
1881622835
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PRESCOTT CLINIC P.C.
Practice address
125 Washington
Prescott, MI 48756
Phone
(989) 873-3352
Fax
(989) 873-3949
NPI assigned
Jun 29, 2006
Last updated
Aug 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Authorized official

Name
Mr. William E Berner
Title
Clinic Administrator
Phone
(989) 892-7722

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X MI Primary

Addresses

Primary practice location

125 Washington
Prescott, MI 48756

Mailing address

125 N Washington St
PO Box 114
Prescott, MI 48756-5117
Phone (989) 892-7722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081121000527 MI Part B Supplier - Clinic/Group Practice 0244147171 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Prescott, MI

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

Practitioners & affiliated clinicians

Practitioners 10

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1881622835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N WASHINGTON ST",
            "address_2": "PO BOX 114",
            "city": "PRESCOTT",
            "state": "MI",
            "postal_code": "487565117",
            "telephone_number": "989-892-7722",
            "fax_number": "989-892-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WASHINGTON",
            "city": "PRESCOTT",
            "state": "MI",
            "postal_code": "48756",
            "telephone_number": "989-873-3352",
            "fax_number": "989-873-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "BERNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "989-892-7722",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.