Organization Active NPI

Uscg Airsta Traverse City Clinic

  • Health Service Clinic/Center
  • Traverse City, MI
National Provider Identifier
1942384409
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
USCG AIRSTA TRAVERSE CITY CLINIC
Practice address
1175 Airport Access Rd
Traverse City, MI 49686-3513
Phone
(231) 922-8282
Fax
(231) 922-8292
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kelly Louise Buttrick, D.D.S.
Title
Chief Health Services
Phone
(231) 922-8282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1175 Airport Access Rd
Traverse City, MI 49686-3513

Mailing address

1175 Airport Access Rd
Traverse City, MI 49686-3513
Phone (231) 922-8282

National Provider Directory

National Provider Directory
Tax ID family
Uscg Clinic St Petersburg65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942384409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 AIRPORT ACCESS RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863513",
            "telephone_number": "231-922-8282",
            "fax_number": "231-922-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 AIRPORT ACCESS RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863513",
            "telephone_number": "231-922-8282",
            "fax_number": "231-922-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USCG AIRSTA TRAVERSE CITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUTTRICK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CHIEF HEALTH SERVICES",
        "authorized_official_telephone_number": "231-922-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.