Psychiatric Physicians, PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301066579 Issued in MI

Legal business name

PSYCHIATRIC PHYSICIANS, PLLC

Doing business as

James P. Wiaduck, M.D.

Practice address

4461 Grand Haven Road
Muskegon, MI 49441

Phone

(231) 798-8337

Fax

(231) 798-9816

NPI assigned

Apr 26, 2007

Last updated

Jan 8, 2020By 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. James Patrick Wiaduck, M.D.NPI 1114946506

Title

Medical Director

Phone

(231) 798-8337

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• James P. Wiaduck, M.D. Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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.

• James Patrick Wiaduck, M.D.

  • Psychiatry Physician
  • Norton Shores, MI
  • NPI 1114946506
  Medicare reassignment Authorized official
• Sandra Kay Alger, LCMSW ACSW

  • Clinical Social Worker
  • Grand Haven, MI
  • NPI 1124110648
  NPD (past)
• Derek L Burt, NP

  • Nurse Practitioner
  • Spring Lake, MI
  • NPI 1811903321
  NPD (past)
• Carrie Jones, CRNA

  • Certified Registered Nurse Anesthetist
  • Commerce Township, MI
  • NPI 1598745077
  NPD (past)
• Alicia Anne Martin, LMSW

  • Clinical Social Worker
  • Muskegon, MI
  • NPI 1306407069
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1982824512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 334",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "49417",
            "telephone_number": "231-798-8337",
            "fax_number": "231-798-9816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 GRAND HAVEN ROAD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "49441",
            "telephone_number": "231-798-8337",
            "fax_number": "231-798-9816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "WIADUCK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "231-798-8337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301066579",
            "primary": true
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "MI",
            "license": "4301066579",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN ON10230",
            "identifier": "PTANON10230",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James P. Wiaduck, M.D.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "James P. Wiaduck, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Professional Med Team (Trinity Health EMS)
• Promising Love Care
• Kambria A Pruitt
• Stevenson Prussner, CCC-SLP
• Lauryn Lynn Przeslawski, D.O.
• Natalie Rebecca Punkay
• Donna Purdy, CNA
• Sharon D Purkis, PT
• Angela Puterbaugh
• Michael Pyne, LSW

• Psychiatry Physician in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.