NPIMap

Organization Active NPI

Three Rivers Health System Inc

Doing business as Family Wellness of Three Rivers

  • Family Medicine Physician
  • Three Rivers, MI
National Provider Identifier
1982194452
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
THREE RIVERS HEALTH SYSTEM INC
Doing business as
Family Wellness of Three Rivers
Practice address
655 S Erie St
Three Rivers, MI 49093-2060
Phone
(269) 273-9746
NPI assigned
May 10, 2018
Last updated
Oct 8, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
THREE RIVERS HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Authorized official

Name
Steven Andrews
Title
Chief Financial Officer
Phone
(269) 278-1145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

655 S Erie St
Three Rivers, MI 49093-2060

Mailing address

711 S Health Pkwy Ste L7
Three Rivers, MI 49093-8354
Phone (269) 273-6949

Other names 1

  • Family Wellness of Three Rivers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140729001948 MI Part B Supplier - Clinic/Group Practice 8729245584 Receives reassigned benefits from 71 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portage, MI; Three Rivers, MI; White Pigeon, MI

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Three Rivers Inc26 organizations share this tax ID, including this one
Part of
Three Rivers Inc

Other organizations with this tax ID 25

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

View all 25

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538956800000",
    "number": "1982194452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S HEALTH PKWY STE L7",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938354",
            "telephone_number": "269-273-6949",
            "fax_number": "269-273-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S ERIE ST",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490932060",
            "telephone_number": "269-273-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS HEALTH SYSTEM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THREE RIVERS HEALTH SYSTEM INC",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-10-08",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "269-278-1145"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Wellness of Three Rivers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Wellness of Three Rivers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Three Rivers, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.