Northern Michigan Physical Medicine PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NORTHERN MICHIGAN PHYSICAL MEDICINE PC

Practice address

2780 Charlevoix Ave
Suite 19
Petoskey, MI 49770-8058

Phone

(231) 347-9800

Fax

(231) 347-9850

NPI assigned

Apr 12, 2007

Last updated

Nov 27, 2007By 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. Gerald Klooster II, D.O.NPI 1639235450

Title

Officer

Phone

(231) 347-9800

Specialties & licenses 1

Addresses

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.

• Gerald Klooster II, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Petoskey, MI
  • NPI 1639235450
  Authorized official Same address or phone

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1912121641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 CHARLEVOIX AVE",
            "address_2": "SUITE 19",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708058",
            "telephone_number": "231-347-9800",
            "fax_number": "231-347-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 CHARLEVOIX AVE",
            "address_2": "SUITE 19",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708058",
            "telephone_number": "231-347-9800",
            "fax_number": "231-347-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MICHIGAN PHYSICAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "KLOOSTER",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "231-347-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Michigan Hematology and Oncology
• Northern Michigan Medical Management
• Northern Michigan Musculoskeletal Medicine PLLC
• Northern Michigan Oral and Maxillofacial Surgery PC
• Northern Michigan Pain Specialists PC
• Northern Michigan Physical Medicine PLC
• Northern Michigan Rehabilitation Specialists, P.C.
• Northern Michigan Rheumatology PC
• Northern Michigan Sports Medicine Center
• Northern Michigan Urology P.C.

• Physical Medicine & Rehabilitation Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.