NPIMap

Organization Active NPI

Alpena Express Care and Family Practice, PLC

  • Family Medicine Physician
  • Alpena, MI
National Provider Identifier
1992981559
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101014566 Issued in MI
Legal business name
ALPENA EXPRESS CARE AND FAMILY PRACTICE, PLC
Practice address
109 S 13TH Ave
Alpena, MI 49707-1609
Phone
(989) 340-0555
Fax
(989) 340-0559
NPI assigned
Jan 14, 2008
Reactivated
Apr 11, 2018
Last updated
May 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Authorized official

Name
David D Dargis, DONPI 1457490609
Title
Owner
Phone
(989) 356-2400

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 Physician 207Q00000X 5101014566 MI Primary

Addresses

Primary practice location

109 S 13TH Ave
Alpena, MI 49707-1609

Mailing address

109 S 13TH Ave
Alpena, MI 49707-1609
Phone (989) 356-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190509001030 MI Part B Supplier - Clinic/Group Practice 4284976473 Receives reassigned benefits from 9 practitioners
Practice locations: Cheboygan, MI; Tawas City, MI; Rogers City, MI; Petoskey, MI; Lincoln, MI; Hillman, MI; Gaylord, MI; Fairview, MI…

National Provider Directory

National Provider Directory

Locations

109 S Thirteenth Ave
Alpena, MI 49707
Phone (989) 356-2400

555 N Bradley Hwy
Ste D
Rogers City, MI 49779
Phone (989) 734-2151

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558051200000",
    "number": "1992981559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 S 13TH AVE",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071609",
            "telephone_number": "989-356-2400",
            "fax_number": "989-354-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S 13TH AVE",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071609",
            "telephone_number": "989-340-0555",
            "fax_number": "989-340-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPENA EXPRESS CARE AND FAMILY PRACTICE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2019-05-17",
        "deactivation_date": "2010-02-01",
        "reactivation_date": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "DARGIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-356-2400",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.