Northern Healthcare PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NORTHERN HEALTHCARE PLLC

Practice address

2057 S M 66
East Jordan, MI 49727-9169

Phone

(231) 649-7109

NPI assigned

Mar 31, 2021

Organization subpart

No

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

Authorized official

Name

Kimberly Nicholls, PA

Title

Owner

Phone

(231) 649-7109

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1932787009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2057 S M 66",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 S M 66",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279169",
            "telephone_number": "231-649-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "NICHOLLS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-649-7109",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay McCulloch, RPH
• Amelia McGeorge
• Monarch Family Chiropractic LLC
• Munson Healthcare Charlevoix Hospital
• Nicole Nichols, PT, DPT
• Keith David Nowak, PHARM. D.
• Kristina K Nowka, AT, PTA
• Jaleesa O'Neal, PT, DPT
• Occupational Planning and Placement
• Cynthia Ann Pepin, LMSW

• Internal Medicine Physician in East Jordan, MI
• Providers in East Jordan, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.