DECKERVILLE COMMUNITY HOSPITAL, INC. (NPI# 1164540555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164540555 |
| Entity Type | Organization |
| Organization Name | DECKERVILLE COMMUNITY HOSPITAL, INC. |
| Practice Address |
3559 Pine Street Deckerville MI 48427 |
| Practice Telephone | 8103762835 |
| Practice Fax Number | 8103769412 |
| Mailing Telephone | 8103762835 |
| Mailing Fax Number | 8103769412 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2017-10-05 |
| Authorized Official Name | KIMBERLY GENTNER (CFO) |
| Authorized Official Telephone | 8103762835 |
| Is Organization Subpart | Y |
| Parent Organization Name | DECKERVILLE COMMUNITY HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | GREAT LAKES HEALTH PLAN | 138358 | 01 |
| MI | BCBSM | G61003 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710485792 | Deckerville Community Hospital, Inc. | Medicare Defined Swing Bed Unit | 3559 Pine St, Deckerville, MI 48427-7703 | 2018-01-25 |
| 1164818977 | Deckerville Community Hospital, Inc. | Orthopaedic Surgery | 3532 Main St, Deckerville, MI 48427-9615 | 2015-04-08 |
| 1780011247 | Deckerville Community Hospital, Inc. | Clinic/Center | 2433 Black River St, Deckerville, MI 48427-9425 | 2013-09-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DECKERVILLE COMMUNITY HOSPITAL, INC. | 3559 Pine St, Deckerville, MI 48427-7703 |
| Street Address |
3559 PINE STREET |
| City | DECKERVILLE |
| State | MI |
| Zip Code | 48427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376579466 | William George Mcnish | Nurse Anesthetist, Certified Registered | 3559 Pine Street, Deckerville, MI 48427 | 2006-06-23 |
| 1619095718 | Deckerville Community Hospital, Inc | General Acute Care Hospital | 3559 Pine Street, Deckerville, MI 48427 | 2007-03-27 |
| 1376626127 | Pany Decossard | Internal Medicine | 3559 Pine Street, Deckerville, MI 48427-0126 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447444591 | Jennifer Ann Lindsey | Social Worker | 6637 Highland Road, Waterford, MI 48427 | 2007-08-31 |
| 1306067400 | Thomas I Hazelton | Dentist | 2382 Black River St, Deckerville, MI 48427 | 2007-05-02 |
| 1588715221 | David Alan Nisbett | Chiropractor | 2515 Maple St., Deckerville, MI 48427 | 2007-01-16 |
| 1902980568 | Dora Lynn Merriman | Registered Nurse | 212 E Sanilac Avenue, Sandusky, MI 48427 | 2006-10-24 |
| 1285714626 | Harold Don Trend | Social Worker | 3474 Palm Street, Deckerville, MI 48427 | 2006-10-17 |
| 1841368362 | Joan Ballentine | Pharmacist | 3482 Main, Deckerville, MI 48427-0067 | 2006-12-01 |
| 1003984527 | Rick Ballentine | Pharmacist | 3482 Main Street, Deckerville, MI 48427-0067 | 2006-12-01 |
| 1710485792 | Deckerville Community Hospital, Inc. | Medicare Defined Swing Bed Unit | 3559 Pine St, Deckerville, MI 48427-7703 | 2018-01-25 |
| 1508299207 | For The Family Counseling Service Pllc | Social Worker | 3466 Main St, Suite 1, Deckerville, MI 48427-7709 | 2013-08-16 |
| 1164901971 | Nicole Miller | Occupational Therapist | 3387 Ella St, Deckerville, MI 48427-7720 | 2018-08-13 |
| Find all providers in zip 48427 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1578163465 | Salta of Auburn Hills | Family Medicine | 2191 S South Blvd, Suite 101c, Pontiac, MI 48326-3481 | 2020-10-29 |
| 1396342606 | Kiwi Virtual Health Care Pllc | Family Medicine | 40618 Blythefield Ln, Canton, MI 48188-2251 | 2020-10-08 |
| 1447867619 | Bashar Yalldo Md Plc | Family Medicine | 14700 Farmington Rd Ste 105, Livonia, MI 48154-5434 | 2020-09-30 |
| 1245847342 | Nuha Bakkal | Family Medicine | 1422 Mill Pond Dr, Waterford, MI 48327-3088 | 2020-09-23 |
| 1710592050 | Chippewa County War Memorial Hospital Inc | Family Medicine | 391 E M 134, Cedarville, MI 49719-9451 | 2020-09-14 |
| 1184238966 | Med Clubs | Family Medicine | 2575 Hummingbird Dr, Holt, MI 48842-9430 | 2020-08-31 |
| 1457961054 | Danna Zevy | Family Medicine | 107 S Washington Ave Apt 401, Saginaw, MI 48607-1258 | 2020-08-07 |
| 1194342808 | Zachary Hillman Do Pllc | Family Medicine | 1794 N Lapeer Rd Ste A, Lapeer, MI 48446-7664 | 2020-06-29 |
| 1336765445 | Spectrum Health United | Family Medicine | 7188 Avenue B, Vestaburg, MI 48891-9502 | 2020-06-24 |
| 1477179711 | Spectrum Health United | Family Medicine | 1324 N County Line Rd, Blanchard, MI 49310-9303 | 2020-06-23 |
| Find all providers with the same taxonomy | ||||
| City | DECKERVILLE |
| Zip Code | 48427 |
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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.