Morenci Medical Assoc PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

062948 Issued in MI

Legal business name

MORENCI MEDICAL ASSOC PC

Practice address

240 W Main St
Morenci, MI 49256-1455

Phone

(517) 458-6848

Fax

(517) 458-7614

NPI assigned

Oct 4, 2007

Last updated

Feb 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shivaprasad K Shetty, M.D.NPI 1235133190

Title

President

Phone

(517) 458-6848

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Morenci Medical Assoc, PC

  • Family Medicine Physician
  • Wauseon, OH
  • NPI 1962690735

  3870495849

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Shivaprasad K Shetty, M.D.

  • Family Medicine Physician
  • Morenci, MI
  • NPI 1235133190
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1891983805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W MAIN ST",
            "city": "MORENCI",
            "state": "MI",
            "postal_code": "492561455",
            "telephone_number": "517-458-6848",
            "fax_number": "517-458-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W MAIN ST",
            "city": "MORENCI",
            "state": "MI",
            "postal_code": "492561455",
            "telephone_number": "517-458-6848",
            "fax_number": "517-458-7614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORENCI MEDICAL ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "SHETTY",
        "authorized_official_first_name": "SHIVAPRASAD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-458-6848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "062948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Morenci (Morenci Area EMS)
• Family Medical Center of Michigan, Inc (Morenci School District)
• Family Medical Center of Michigan,Inc (Family Medical Center-Morenci Elementary School)
• William J Gray, MD
• Highland Road Plaza LLC (Mike Pharmacy)
• Carrie Murphy, BSW
• Jeffrey A. Robichaud, D.D.S.
• Lance Matthew Shaffer, D.C.
• Shivaprasad K Shetty, M.D.
• Rachel Lee Shoemaker

• Family Medicine Physician in Morenci, MI
• Providers in Morenci, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.