Prescott Clinic P.C.
Organization Active NPI Rural Health Clinic/Center · Prescott, MI
NPI 1881622835 · NPPES record last updated Aug 15, 2018
Key facts
- NPI
- 1881622835
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Mr. William E Berner
- Title
- Clinic Administrator
- Phone
- (989) 892-7722
Other NPIs on the same Medicare enrollment 1
Practitioners 8
-
Melinda Lee Hawley, FNP-C
-
Nicholas Orow, M.D.
-
Richard Steven Gaft, ANCC, FNP
-
Linda Samborn, DO
-
Clinton Cornell, P.A.-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | MI | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 233873 | Other | RIVERBEND | |
| 010F510190 | Other | MI | BCBS |
| 114303974 | Medicaid | MI |
Other providers in Prescott, MI
- Karen'S Accounting Service, LLC
- Mad World Wellness PLLC
- Antonio F Mendiola Jr.
- Annemarie Catherine Poleck
- Prescott Clinic P.C.
- Prescott Physical Therapy, LLC
- Roos Pharmacy North, Inc.
- Skidway Pharmacy LLC
- Sterling Area Health Center
- Gabriel Wayne Wallace
All providers in Prescott, MI · Rural Health Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.