NPIMap

Organization Active NPI

Superior Walk-in Center, PC

Doing business as Superior Walk-In & Family Health

  • Family Medicine Physician
  • Marquette, MI
National Provider Identifier
1992167241
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301058344 Issued in MI
Legal business name
SUPERIOR WALK-IN CENTER, PC
Doing business as
Superior Walk-In & Family Health
Practice address
2382 US Highway 41 W
Marquette, MI 49855-2456
Phone
(906) 449-2005
Fax
(906) 449-2007
NPI assigned
Mar 25, 2016
Last updated
Mar 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Authorized official

Name
Kurt Richard Olson, M.D.NPI 1457309569
Title
President/ Owner
Phone
(906) 387-4220

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: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 4301058344 MI Primary

Addresses

Primary practice location

2382 US Highway 41 W
Marquette, MI 49855-2456

Mailing address

1504 Sandpoint Rd
Munising, MI 49862-1406
Phone (906) 387-4220

Other names 1

  • Superior Walk-In & Family Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070123000220 MI Part B Supplier - Clinic/Group Practice 6204837057 Receives reassigned benefits from 14 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marquette, MI; Munising, MI

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Superior Walk-in Center PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1992167241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 SANDPOINT RD",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "498621406",
            "telephone_number": "906-387-4220",
            "fax_number": "906-387-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2382 US HIGHWAY 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552456",
            "telephone_number": "906-449-2005",
            "fax_number": "906-449-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR WALK-IN CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "906-387-4220",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301058344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Walk-In & Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.