Individual provider Active NPI

Amy Patel Couturier, MD

  • Pediatrics Physician
  • Traverse City, MI
National Provider Identifier
1902224215
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301503517 Issued in MI
Practice address
802 S Garfield Ave Ste C
Traverse City, MI 49686-3487
Phone
(231) 714-4193
Fax
(952) 333-7883
NPI assigned
Apr 3, 2014
Last updated
Jul 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 149706 CA
Pediatrics Physician 208000000X 4301503517 MI Primary

Addresses

Primary practice location

802 S Garfield Ave Ste C
Traverse City, MI 49686-3487

Mailing address

802 S Garfield Ave Ste C
Traverse City, MI 49686-3487
Phone (231) 714-4193

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.uporthpediatrics.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
149706CAMDMarriage & Family Therapist
4301503517MIMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1902224215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 S GARFIELD AVE STE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863487",
            "telephone_number": "231-714-4193",
            "fax_number": "952-333-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 S GARFIELD AVE STE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863487",
            "telephone_number": "231-714-4193",
            "fax_number": "952-333-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUTURIER",
        "first_name": "AMY",
        "middle_name": "PATEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "149706",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301503517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.uporthpediatrics.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "802 S Garfield Ave Ste C",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496863487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.