Michigan Independent Physicians Association, PLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MICHIGAN INDEPENDENT PHYSICIANS ASSOCIATION, PLC

Doing business as

Michigan IPA

Practice address

12821 S Saginaw St
D13
Grand Blanc, MI 48439-2457

Phone

(810) 344-9213

Fax

(810) 953-2964

NPI assigned

May 19, 2016

Last updated

Jun 23, 2016By 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

Robert Maurice Bouvier, MD

Title

Ceo

Phone

(810) 610-7972

Specialties & licenses 9

Addresses

Other names 1

• Michigan IPA Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Robert Bouvier MD, PLC

  • Family Medicine Physician
  • Grand Blanc, MI
  • NPI 1700049616

  O20080823000092

  Same enrollment

Locations

Practitioners 2

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.

• Salwa Sirelkatim Mohamedahmed, MD

  • Internal Medicine Physician
  • Davison, MI
  • NPI 1689867186
  NPD
• Jon L Schriner, D.O.

  • Family Medicine Physician
  • Grand Blanc, MI
  • NPI 1902951809
  NPD

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1912354986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12821 S SAGINAW ST",
            "address_2": "D13",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392457",
            "telephone_number": "810-344-9213",
            "fax_number": "810-953-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12821 S SAGINAW ST",
            "address_2": "D13",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392457",
            "telephone_number": "810-344-9213",
            "fax_number": "810-953-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN INDEPENDENT PHYSICIANS ASSOCIATION, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "BOUVIER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MAURICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-610-7972",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan IPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.