NPIMap

Organization Active NPI

DLP Marquette Physician Practices Inc

Doing business as Marquette General Radiology

  • Diagnostic Radiology Physician
  • Marquette, MI
National Provider Identifier
1902157027
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DLP MARQUETTE PHYSICIAN PRACTICES INC
Doing business as
Marquette General Radiology
Practice address
420 W Magnetic St
Marquette, MI 49855-2700
Phone
(906) 225-3466
NPI assigned
Sep 28, 2012
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
DLP MARQUETTE PHYSICIAN PRACTICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Authorized official

Name
Jess Judy
Title
President
Phone
(615) 372-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

420 W Magnetic St
Marquette, MI 49855-2700

Mailing address

420 W Magnetic St
Marquette, MI 49855-2700
Phone (906) 225-3466

Other identifiers 1

IdentifierTypeStateIssuer
1902157027MedicaidMI

Other names 1

  • MARQUETTE GENERAL RADIOLOGY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121016000312 MI Part B Supplier - Clinic/Group Practice 9931359601 Receives reassigned benefits from 467 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marquette, MI; Negaunee, MI; Newberry, MI; Escanaba, MI; Ontonagon, MI; Sault Sainte Marie, MI; Ternary, MI; Manistique, MI…

Other NPIs on the same Medicare enrollment 33

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

View all 33

National Provider Directory

National Provider Directory
Part of
DLP Marquette Phys Prac LLC

Locations

420 W Magnetic St
Marquette, MI 49855
Phone (906) 225-3540

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1902157027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552700",
            "telephone_number": "906-225-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552700",
            "telephone_number": "906-225-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP MARQUETTE PHYSICIAN PRACTICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DLP MARQUETTE PHYSICIAN PRACTICES INC",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "JESS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-372-8500"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902157027",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARQUETTE GENERAL RADIOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.