NPIMap

Organization Active NPI

Saginaw Valley Family Care, PLLC

Doing business as Saginaw Valley Family Care

  • Family Medicine Physician
  • Saginaw, MI
National Provider Identifier
1992270870
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAGINAW VALLEY FAMILY CARE, PLLC
Doing business as
Saginaw Valley Family Care
Practice address
5200 State St
Saginaw, MI 48603-3713
Phone
(989) 793-4250
Fax
(989) 793-6880
NPI assigned
Oct 8, 2018
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Mrs. Bethany E Malott, PA-CNPI 1215128962
Title
Physician Assistant
Phone
(989) 793-4250

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X

Addresses

Primary practice location

5200 State St
Saginaw, MI 48603-3713

Mailing address

4386 State St
Saginaw, MI 48603-4067
Phone (989) 793-4250

Other names 1

  • Saginaw Valley Family Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190109000699 MI Part B Supplier - Clinic/Group Practice 4587900774 Receives reassigned benefits from 8 practitioners
Practice locations: Saginaw, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0929210Saginaw Valley Family Care5200 State Street, Saginaw, MI 48603Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory

Locations

4386 State St
Ste 3
Saginaw, MI 48603
Phone (989) 793-4250

5200 State St
Saginaw, MI 48603
Phone (989) 793-4250

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1992270870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4386 STATE ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486034067",
            "telephone_number": "989-793-4250",
            "fax_number": "989-793-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 STATE ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486033713",
            "telephone_number": "989-793-4250",
            "fax_number": "989-793-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGINAW VALLEY FAMILY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "MALOTT",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "989-793-4250",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saginaw Valley Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.