Soma Medical Clinic, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

4301102383 Issued in MI

Legal business name

SOMA MEDICAL CLINIC, LLC

Practice address

955 S Bailey Ave
South Haven, MI 49090-6743

Phone

(269) 637-5271

Fax

(269) 639-2919

NPI assigned

Sep 30, 2006

Organization subpart

No

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

Authorized official

Name

Angie Oetman

Title

Medical Staff Coordinator

Phone

(269) 639-2807

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ewa Osolkowski, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1174637326
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1952494353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490906743",
            "telephone_number": "269-637-5271",
            "fax_number": "269-639-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490906743",
            "telephone_number": "269-637-5271",
            "fax_number": "269-639-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMA MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "OETMAN",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "MEDICAL STAFF COORDINATOR",
        "authorized_official_telephone_number": "269-639-2807"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "042007627",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MI",
            "license": "4301102383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Grant Shields, LMSW
• Melanie Ann Skindzier Gleiss, DC
• Anne Slachta, PA-C
• Matthew G Small, MD
• Scott Eric Smith, OTR
• Alisa A Somers, DPT
• South Coast Home LLC
• South Haven Area Emergency Services Authority
• South Haven Chiropractic Clinic
• South Haven Community Health System

• General Acute Care Hospital in South Haven, MI
• Providers in South Haven, MI by specialty
• General Acute Care Hospital in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.