Grand Traverse Womens Clinic

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

4704273686 Issued in MI

Legal business name

GRAND TRAVERSE WOMENS CLINIC

Practice address

1200 Sixth St
Ste 400
Traverse City, MI 49684-2369

Phone

(231) 392-0655

Fax

(231) 392-0691

NPI assigned

Oct 5, 2012

Last updated

Feb 24, 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

Ms. Barbara RogersNPI 1295153062

Title

Credentialing Specialist

Phone

(231) 392-0655

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Grand Traverse Womens Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grand Traverse Womens Clinic

  • Midwife
  • Traverse City, MI
  • NPI 1558483362
  NPD tax ID

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.

• Barbara Rogers

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Traverse City, MI
  • NPI 1295153062
  Authorized official Same address or phone
• Meghan Visnick Davis, CNMW

  • Women's Health Nurse Practitioner
  • Traverse City, MI
  • NPI 1033458534
  NPD (past)

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1942552559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST",
            "address_2": "STE 400",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-392-0655",
            "fax_number": "231-392-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST",
            "address_2": "STE 400",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-392-0655",
            "fax_number": "231-392-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TRAVERSE WOMENS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "231-392-0655",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MI",
            "license": "4704273686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704273686",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grand Traverse Primary Care PLC
• Grand Traverse Radiologists PC
• Grand Traverse Resource Center
• Grand Traverse Surgery P.C.
• Grand Traverse Womens Clinic
• Grand Traverse Womens Clinic PLLC
• Grandview Dental Associates PLLC
• Grandview Dental Care PLLC
• Kaitlyn Grangood, LMSW, CBIS
• Carrie Lee Grant

• Obstetrics & Gynecology Nurse Practitioner in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Obstetrics & Gynecology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.