Individual provider Active NPI

Medley Larkin, D.O.

  • Gastroenterology Physician
  • Saginaw, MI
National Provider Identifier
1992782569
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
5101007897 Issued in MI
Practice address
4680 McLeod Dr E
Saginaw, MI 48604-2852
Phone
(989) 791-9133
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101007897 MI
Gastroenterology Physician 207RG0100X 5101007897 MI Primary

Addresses

Primary practice location

4680 McLeod Dr E
Saginaw, MI 48604-2852

Mailing address

PO Box 779
Tawas City, MI 48764-0779
Phone (989) 791-9133

Other identifiers 2

IdentifierTypeStateIssuer
110010368OtherMIRR MEDICARE
2931936MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101007897MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Towne Centre Surgery Center, LLC Current Accepting new patients
Medley a Larkin D O P C Gastroenterology PastSince Jul 1, 1981 Accepting new patients

Locations

4599 Towne Centre Rd
Saginaw, MI 48604
Phone (989) 497-3000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1992782569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487640779",
            "telephone_number": "989-791-9133",
            "fax_number": "989-791-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 MCLEOD DR E",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042852",
            "telephone_number": "989-791-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARKIN",
        "first_name": "MEDLEY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101007897",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "5101007897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110010368",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2931936",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 23, 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.