NPIMap

Organization Active NPI

Michigan Eldercare, Inc.

Doing business as Mobile Doctors of Northwest Michigan

  • Geriatric Medicine (Family Medicine) Physician
  • Williamsburg, MI
National Provider Identifier
1962568956
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
MICHIGAN ELDERCARE, INC.
Doing business as
Mobile Doctors of Northwest Michigan
Practice address
6100 US 31 North
Williamsburg, MI 49690
Phone
(231) 938-5983
Fax
(231) 938-7019
NPI assigned
Dec 28, 2006
Last updated
Aug 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Authorized official

Name
Mr. Larry Robert Knight
Title
President
Phone
(231) 938-5983

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X Primary

Addresses

Primary practice location

6100 US 31 North
Williamsburg, MI 49690

Mailing address

PO Box 515
Acme, MI 49610-0515
Phone (231) 938-5983

Other identifiers 1

IdentifierTypeStateIssuer
5845760MedicaidMI

Other names 1

  • Mobile Doctors of Northwest Michigan Doing business as

National Provider Directory

National Provider Directory

Locations

3877 M 72 E
Williamsburg, MI 49690
Phone (231) 938-5983

6100 US Highway 31 N
Williamsburg, MI 49690
Phone (231) 938-5983

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1962568956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515",
            "city": "ACME",
            "state": "MI",
            "postal_code": "496100515",
            "telephone_number": "231-938-5983",
            "fax_number": "231-938-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 US 31 NORTH",
            "city": "WILLIAMSBURG",
            "state": "MI",
            "postal_code": "49690",
            "telephone_number": "231-938-5983",
            "fax_number": "231-938-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN ELDERCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-08-13",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-938-5983",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5845760",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Doctors of Northwest Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsburg, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.