NPIMap

Organization Active NPI

Van Buren/Cass District Health Department

  • Public Health Dentistry
  • Dowagiac, MI
National Provider Identifier
1982796140
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
Legal business name
VAN BUREN/CASS DISTRICT HEALTH DEPARTMENT
Practice address
302 South Front Street
Dowagiac, MI 49047-1762
Phone
(269) 782-0064
Fax
(269) 782-0121
NPI assigned
Sep 28, 2006
Last updated
Jan 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name
Jeffery L Elliott
Title
Health Officer/Administrator
Phone
(269) 621-3143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X NU Primary

Addresses

Primary practice location

302 South Front Street
Dowagiac, MI 49047-1762

Mailing address

57418 County Road 681
Suite a
Hartford, MI 49057-9421
Phone (269) 621-3143

Other identifiers 2

IdentifierTypeStateIssuer
4304111MedicaidMI
4977200MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Van Buren Cass District Public Health Department18 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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1982796140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57418 COUNTY ROAD 681",
            "address_2": "SUITE A",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490579421",
            "telephone_number": "269-621-3143",
            "fax_number": "269-621-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 SOUTH FRONT STREET",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490471762",
            "telephone_number": "269-782-0064",
            "fax_number": "269-782-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN BUREN/CASS DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "HEALTH OFFICER/ADMINISTRATOR",
        "authorized_official_telephone_number": "269-621-3143"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4304111",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4977200",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dowagiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.