NPIMap

Organization Active NPI

WKQ Inc Dba Northside Immediate Care Center

  • Preferred Provider Organization
  • N Muskegon, MI
National Provider Identifier
1912195876
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
WKQ INC DBA NORTHSIDE IMMEDIATE CARE CENTER
Practice address
420 Whitehall Rd
Suite 4
N Muskegon, MI 49445-3299
Phone
(231) 744-4743
Fax
(231) 744-4745
NPI assigned
Oct 4, 2007
Last updated
Oct 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Dr. Erwin L Grasman, M.D.NPI 1780779298
Title
Owner/President
Phone
(231) 744-4743

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X Primary

Addresses

Primary practice location

420 Whitehall Rd
Suite 4
N Muskegon, MI 49445-3299

Mailing address

420 Whitehall Rd
Suite 4
N Muskegon, MI 49445-3299
Phone (231) 744-4743

Other identifiers 2

IdentifierTypeStateIssuer
0F16019OtherMNBCBS MI
0F11097OtherMIBCN UCC

Other names 1

  • northside immediate care urgent care Other name

National Provider Directory

National Provider Directory

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": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1912195876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WHITEHALL RD",
            "address_2": "SUITE 4",
            "city": "N MUSKEGON",
            "state": "MI",
            "postal_code": "494453299",
            "telephone_number": "231-744-4743",
            "fax_number": "231-744-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WHITEHALL RD",
            "address_2": "SUITE 4",
            "city": "N MUSKEGON",
            "state": "MI",
            "postal_code": "494453299",
            "telephone_number": "231-744-4743",
            "fax_number": "231-744-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WKQ INC DBA NORTHSIDE IMMEDIATE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "GRASMAN",
        "authorized_official_first_name": "ERWIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "231-744-4743",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "0F16019",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN UCC",
            "identifier": "0F11097",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "northside immediate care urgent care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in N Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.