NPIMap

Organization Active NPI

Pulmonary Clinics of Southern Michigan

  • Pulmonary Disease Physician
  • Jackson, MI
National Provider Identifier
1992818207
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY CLINICS OF SOUTHERN MICHIGAN
Practice address
517 Wildwood Ave
Jackson, MI 49201-1094
Phone
(517) 782-3190
Fax
(517) 782-1223
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Authorized official

Name
Ashley Peterson
Title
Office Manager
Phone
(517) 782-3190

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X

Addresses

Primary practice location

517 Wildwood Ave
Jackson, MI 49201-1094

Mailing address

517 Wildwood Ave
Jackson, MI 49201-1094
Phone (517) 782-3190

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050406001085 MI Part B Supplier - Clinic/Group Practice 4284681784 Receives reassigned benefits from 14 practitioners
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory

Locations

900 E Michigan Ave
#271
Jackson, MI 49201

900 E Michigan Ave
Ste 1
Jackson, MI 49201
Phone (517) 788-7866

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1992818207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 WILDWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011094",
            "telephone_number": "517-782-3190",
            "fax_number": "517-782-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 WILDWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011094",
            "telephone_number": "517-782-3190",
            "fax_number": "517-782-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY CLINICS OF SOUTHERN MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "517-782-3190"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.