NPIMap

Organization Active NPI

Delta Family Clinic South PC

Doing business as Delta Family Clinic

  • Clinical Psychologist
  • Bay City, MI
National Provider Identifier
1902162746
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DELTA FAMILY CLINIC SOUTH PC
Doing business as
Delta Family Clinic
Practice address
901 N. Euclid Ave.
Bay City, MI 48706
Phone
(989) 671-9798
NPI assigned
Apr 5, 2012
Last updated
Apr 5, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
DELTA FAMILY CLINIC SOUTH P.CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Gerard Williams, PH.DNPI 1821158817
Title
Cfo/ Adnimistrator
Phone
(810) 630-1152

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

901 N. Euclid Ave.
Bay City, MI 48706

Mailing address

6195 Miller Rd.
Ste. a
Swartz Creek, MI 48473
Phone (810) 630-1152

Other names 1

  • Delta Family Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Delta Family Clinic South PC3 organizations share this tax ID, including this one
Part of
Delta Family Clinic South PC

Other organizations with this tax ID 2

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

Locations

901 N Euclid Ave
Bay City, MI 48706
Phone (989) 671-9798

6195 Miller Rd
Ste A
Swartz Creek, MI 48473
Phone (810) 630-1152

Practitioners & affiliated clinicians

Practitioners 6

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": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1902162746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6195 MILLER RD.",
            "address_2": "STE. A",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "48473",
            "telephone_number": "810-630-1152",
            "fax_number": "810-630-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N. EUCLID AVE.",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "48706",
            "telephone_number": "989-671-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA FAMILY CLINIC SOUTH PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DELTA FAMILY CLINIC SOUTH P.C",
        "enumeration_date": "2012-04-05",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "GERARD",
        "authorized_official_title_or_position": "CFO/ ADNIMISTRATOR",
        "authorized_official_telephone_number": "810-630-1152",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bay City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.