Mercy Surgery Care Network

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

MERCY SURGERY CARE NETWORK

Doing business as

Mercy Endocrinology

Practice address

4190 24TH Ave
Suite 206
Fort Gratiot, MI 48059-3882

Phone

(810) 989-7478

Fax

(810) 989-7644

NPI assigned

Jun 24, 2014

Last updated

Jul 7, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

TRINITY HEALTH MICHIGANAs reported in NPPES

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

Authorized official

Name

Nancy Mason

Title

Executive Director

Phone

(810) 985-1868

Specialties & licenses 1

Addresses

Other names 1

• Mercy Endocrinology Doing business as

Part of

St Johns Hospital

Locations

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1942615414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610669",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480610669",
            "telephone_number": "810-987-1029",
            "fax_number": "810-966-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE",
            "address_2": "SUITE 206",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593882",
            "telephone_number": "810-989-7478",
            "fax_number": "810-989-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY SURGERY CARE NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY HEALTH MICHIGAN",
        "enumeration_date": "2014-06-24",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "810-985-1868"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Endocrinology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endocrinology, Diabetes & Metabolism Physician in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Endocrinology, Diabetes & Metabolism Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.