NPIMap

Organization Active NPI

Terrence W. Tatarchuk, M.D., P.C.

  • Specialist
  • Cadillac, MI
National Provider Identifier
1962670562
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301039879 Issued in MI
Legal business name
TERRENCE W. TATARCHUK, M.D., P.C.
Practice address
8795 Pine Ridge Dr
Suite B
Cadillac, MI 49601-9777
Phone
(231) 775-1306
Fax
(231) 775-9701
NPI assigned
Feb 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Authorized official

Name
Rose Tompkins
Title
Office Manager
Phone
(231) 775-1306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 4301039879 MI Primary

Addresses

Primary practice location

8795 Pine Ridge Dr
Suite B
Cadillac, MI 49601-9777

Mailing address

8795 Pine Ridge Dr
Suite B
Cadillac, MI 49601-9777
Phone (231) 775-1306

Other identifiers 1

IdentifierTypeStateIssuer
2093804MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1962670562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8795 PINE RIDGE DR",
            "address_2": "SUITE B",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496019777",
            "telephone_number": "231-775-1306",
            "fax_number": "231-775-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8795 PINE RIDGE DR",
            "address_2": "SUITE B",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496019777",
            "telephone_number": "231-775-1306",
            "fax_number": "231-775-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRENCE W. TATARCHUK, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "TOMPKINS",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "231-775-1306"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301039879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2093804",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.