NPIMap

Organization Active NPI

Michigan-Wisconsin Family Practice Associates, P.C.

  • Family Medicine Physician
  • Iron Mountain, MI
National Provider Identifier
1992141352
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MICHIGAN-WISCONSIN FAMILY PRACTICE ASSOCIATES, P.C.
Practice address
1711 S Stephenson Ave
Suite 300
Iron Mountain, MI 49801-3650
Phone
(906) 774-1633
Fax
(906) 774-4451
NPI assigned
May 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

Name
Beth SchroederNPI 1184616013
Title
Owner
Phone
(906) 774-1633

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MI Primary

Addresses

Primary practice location

1711 S Stephenson Ave
Suite 300
Iron Mountain, MI 49801-3650

Mailing address

1711 S Stephenson Ave
Suite 300
Iron Mountain, MI 49801-3650
Phone (906) 774-1633

Other identifiers 2

IdentifierTypeStateIssuer
0B21061OtherMIBCBS OF MI
43055200MedicaidWI

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": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1992141352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE",
            "address_2": "SUITE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE",
            "address_2": "SUITE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN-WISCONSIN FAMILY PRACTICE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "906-774-1633"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "0B21061",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43055200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.