ASCENSION MEDICAL GROUP PROMED (NPI# 1063542165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063542165 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP PROMED |
| Practice Address |
7895 Currier Dr Portage MI 49002-4314 |
| Mailing Address |
1717 Shaffer St Ste 2 Kalamazoo MI 49048-1623 |
| Practice Telephone | 2693217090 |
| Mailing Telephone | 2695522836 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | DAMON D. SORENSEN (CFO) |
| Authorized Official Telephone | 2692265607 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM GROUP # | 750910577 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538299631 | Ascension Medical Group Promed | Internal Medicine | 7895 Currier Dr, Portage, MI 49002-4314 | 2007-03-07 |
| 1437201811 | Ascension Medical Group Promed | Obstetrics & Gynecology | 3025 Gull Rd, Ste 250, Kalamazoo, MI 49048-1281 | 2007-01-17 |
| 1013926997 | Ascension Medical Group Promed | Obstetrics & Gynecology | 8001 Angling Rd, Portage, MI 49024-7422 | 2006-08-07 |
| 1720009954 | Ascension Medical Group Promed | Internal Medicine | 1717 Shaffer St, Ste 124, Kalamazoo, MI 49048-1647 | 2006-07-22 |
| 1497709869 | Ascension Medical Group Promed | Internal Medicine | 7901 Angling Rd, Portage, MI 49024-0714 | 2006-05-20 |
| Street Address |
7895 CURRIER DR |
| City | PORTAGE |
| State | MI |
| Zip Code | 49002-4314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528025400 | Ann E. Crabb | Counselor | 7895 Currier Dr, Portage, MI 49002-4314 | 2006-04-26 |
| 1538459813 | Amber Rachelle Nash-guilford | Obstetrics & Gynecology | 7895 Currier Dr, Portage, MI 49002-4314 | 2011-04-08 |
| 1841483567 | Dayanthi Nishani Samaraweera | Psychologist | 7895 Currier Dr, Portage, MI 49002-4314 | 2007-08-27 |
| 1932306016 | Karen A Spaude | Dietitian, Registered | 7895 Currier Dr, Portage, MI 49002-4314 | 2007-07-02 |
| 1437352689 | Niaz Mohammad | Psychiatry & Neurology | 7895 Currier Dr, Portage, MI 49002-4314 | 2007-06-06 |
| 1538299631 | Ascension Medical Group Promed | Internal Medicine | 7895 Currier Dr, Portage, MI 49002-4314 | 2007-03-07 |
| 1629136429 | Promed Healthcare | Durable Medical Equipment & Medical Supplies | 7895 Currier Dr, Portage, MI 49002-4314 | 2006-12-05 |
| 1821171554 | Cheryl Tenenbaum | Dietitian, Registered | 7895 Currier Dr, Portage, MI 49002-4314 | 2006-10-24 |
| 1467535575 | Joyce Ross | Dietitian, Registered | 7895 Currier Dr, Portage, MI 49002-4314 | 2006-10-23 |
| 1073603791 | Deborah Esteves | Internal Medicine | 7895 Currier Dr, Portage, MI 49002-4314 | 2006-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604204 | Susan Vandewalker | Physical Therapist | 8001 Angling Rd., Portage, MI 49002 | 2018-03-28 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1386045383 | Pinnacle Senior Care of Kalamazoo, LLC | Home Health | 2725 Airview Blvd Ste 105b, Portage, MI 49002 | 2014-09-09 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1619211919 | Daketia L Thomas | Massage Therapist | 8314 Portage Rd, Suite D, Kalamazoo, MI 49002 | 2012-11-27 |
| 1831457142 | Kinetic Kids, LLC | Occupational Therapist | 540 East Milham, Portage, MI 49002 | 2012-04-25 |
| 1154689404 | Lauren Michelle Mattaliano | Occupational Therapist | 540 E. Milham Road, Portage, MI 49002 | 2012-04-24 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
| Find all providers in zip 49002 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457915647 | Rise: Counseling Group and Holistic Wellness Center LLC | Counselor | 1818 W Centre Ave, Portage, MI 49024-5332 | 2019-04-24 |
| 1578921193 | Jennifer Buysse | Counselor | 6749 Buckhorn St, Portage, MI 49024-3316 | 2016-02-10 |
| 1134566763 | Sarah Webb | Counselor | 1591 W Centre Ave, Suite 102, Portage, MI 49024-6314 | 2013-05-22 |
| 1629313754 | Julie Marie Sorenson | Counselor | 1611 W Centre Ave Ste 200, Portage, MI 49024-5393 | 2012-11-29 |
| 1508160771 | Nedward B;aine Moore IIi | Counselor | 220 Plane Rd, Portage, PA 15946-6704 | 2011-01-03 |
| 1982938254 | Roberta J Taber | Counselor | 320 Library Ln, Portage, MI 49002-4303 | 2009-09-19 |
| 1992981369 | Elizabeth Alice Gass-boshoven | Counselor | 3021 Fleetwood Dr, Portage, MI 49024-5607 | 2008-01-16 |
| 1154967818 | Corinne S Truxal | Counselor | 2639 New Pinery Rd Ste 1, Portage, WI 53901-1110 | 2019-11-18 |
| 1053953208 | Amy Albertson | Counselor | 1651 W Centre Ave, Portage, MI 49024-6312 | 2019-10-09 |
| 1962068445 | Ruth Newhouse | Counselor | 8145 Valleywood Ln Ste B, Portage, MI 49024-5296 | 2019-05-10 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.