Organization Active NPI

Stephen B Reznicek M.D. P.C.

  • Urology Physician
  • Cadillac, MI
National Provider Identifier
1982891180
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
STEPHEN B REZNICEK M.D. P.C.
Practice address
1011 Sunnyside Dr
Cadillac, MI 49601-8735
Phone
(231) 779-2565
Fax
(231) 775-0744
NPI assigned
Oct 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
Dr. Stephen B Reznicek, M.D.NPI 1801846704
Title
President
Phone
(231) 779-2565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

1011 Sunnyside Dr
Cadillac, MI 49601-8735

Mailing address

1011 Sunnyside Dr
Cadillac, MI 49601-8735
Phone (231) 779-2565

Other identifiers 1

IdentifierTypeStateIssuer
3408300152OtherMIBLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1982891180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 SUNNYSIDE DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018735",
            "telephone_number": "231-779-2565",
            "fax_number": "231-775-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 SUNNYSIDE DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018735",
            "telephone_number": "231-779-2565",
            "fax_number": "231-775-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN B REZNICEK M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "REZNICEK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-779-2565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3408300152",
            "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 Jan 9, 2008; 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.