Family Gastroenterology P L L C

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301064684 Issued in MI

Legal business name

FAMILY GASTROENTEROLOGY P L L C

Practice address

805 W Cedar St
Standish, MI 48658-9526

Phone

(989) 846-3555

Fax

(989) 846-3462

NPI assigned

Aug 28, 2012

Last updated

Aug 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ibrahim S Shamieh, MDNPI 1629026463

Title

Owner/Physician

Phone

(989) 846-3500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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.

• Ibrahim S Shamieh, MD

  • Gastroenterology Physician
  • Standish, MI
  • NPI 1629026463
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1972851608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486580125",
            "telephone_number": "989-846-3500",
            "fax_number": "989-846-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W CEDAR ST",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486589526",
            "telephone_number": "989-846-3555",
            "fax_number": "989-846-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY GASTROENTEROLOGY P L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "SHAMIEH",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "989-846-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301064684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Standish, MI
• Providers in Standish, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.