NPIMap

Organization Active NPI

McLaren Flint

  • Psychologist
  • Flint, MI
National Provider Identifier
1962541318
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MCLAREN FLINT
Practice address
4448 Oakbridge Dr
Flint, MI 48532
Phone
(810) 342-5333
NPI assigned
Feb 5, 2007
Last updated
Aug 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Authorized official

Name
Mr. Fred Korte
Title
Cfo
Phone
(810) 342-2000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary
Clinical Psychologist 103TC0700X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

4448 Oakbridge Dr
Flint, MI 48532

Mailing address

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

Other identifiers 1

IdentifierTypeStateIssuer
680B512650OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041020000055 MI Part B Supplier - Clinic/Group Practice 8628975497 Receives reassigned benefits from 17 practitioners
Practice locations: Flint, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
McLaren Pulmonary C18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

5057 W Bristol Rd
Flint, MI 48507
Phone (810) 733-1492

G3200 Beecher Rd
Ste Mbi
Flint, MI 48532
Phone (810) 342-5470

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1962541318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638",
            "telephone_number": "810-342-2000",
            "fax_number": "810-342-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4448 OAKBRIDGE DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48532",
            "telephone_number": "810-342-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN FLINT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "KORTE",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "810-342-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "680B512650",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.