PORTAGE HOSPITAL LLC (NPI# 1366879199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366879199 |
| Entity Type | Organization |
| Organization Name | PORTAGE HOSPITAL LLC |
| Other Organization Name | PORTAGE HEALTH DIALYSIS CENTER |
| Practice Address |
500 Campus Dr Hancock MI 49930-1569 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-4536 |
| Practice Telephone | 9064831000 |
| Mailing Telephone | 6159207000 |
| Mailing Fax Number | 6159208913 |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2019-07-19 |
| Authorized Official Name | KATHY J. TEAGUE (SECRETARY) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Portage Health Dialysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285061010 | Portage Hospital LLC | Hospice Care, Community Based | 821 W Water St, Hancock, MI 49930-1953 | 2013-10-11 |
| 1134574940 | Portage Hospital LLC | Emergency Response System Companies | 821 W Water St, Hancock, MI 49930-1953 | 2016-04-29 |
| 1073943783 | Portage Hospital LLC | Dietitian, Registered | 500 Campus Dr, Hancock, MI 49930-1569 | 2013-11-15 |
| 1477981124 | Portage Hospital LLC | Home Health | 821 W Water St, Hancock, MI 49930-1953 | 2013-10-16 |
| 1821425612 | Portage Hospital LLC | Medicare Defined Swing Bed Unit | 500 Campus Dr, Hancock, MI 49930-1569 | 2013-10-11 |
| 1104253921 | Portage Hospital LLC | Skilled Nursing Facility | 520 Campus Dr, Hancock, MI 49930-1569 | 2013-10-11 |
| 1174950901 | Portage Hospital LLC | Hearing Aid Equipment | 500 Campus Dr, Hancock, MI 49930-1569 | 2013-10-11 |
| 1710314547 | Portage Hospital LLC | Durable Medical Equipment & Medical Supplies | 500 Campus Dr, Hancock, MI 49930-1569 | 2013-10-11 |
| 1245667229 | Portage Hospital LLC | General Acute Care Hospital | 500 Campus Dr, Hancock, MI 49930-1569 | 2013-10-04 |
| Street Address |
500 CAMPUS DR |
| City | HANCOCK |
| State | MI |
| Zip Code | 49930-1569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215931068 | Portage Health Inc | Emergency Medicine | 500 Campus Dr, Hancock, MI 49930-1569 | 2005-06-09 |
| 1376182931 | Melissa Sue Meier | Nurse Practitioner | 500 Campus Dr, Hancock, MI 49930-1452 | 2019-12-31 |
| 1336786078 | Jeremy Michael Nicoski | Nurse Anesthetist, Certified Registered | 500 Campus Dr, Hancock, MI 49930-1452 | 2019-12-02 |
| 1548805005 | Shana Louise Roth | Dietitian, Registered | 500 Campus Dr, Hancock, MI 49930-1452 | 2019-11-08 |
| 1902365752 | Natalie Sloan Hupp | Physical Therapist | 500 Campus Dr, Hancock, MI 49930-1452 | 2019-03-19 |
| 1891267571 | Jenny Dice | Pharmacist | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-12-19 |
| 1700354149 | Jessie Rae Salo | Nurse Practitioner | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-11-04 |
| 1154806206 | Brittany Andrianna Wadaga | Registered Nurse | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-09-25 |
| 1417442898 | Concierge Dermatology & Skin Surgery Center | Dermatology | 500 Campus Dr, Hancock, MI 49930 | 2018-06-27 |
| 1306343918 | Stephanie Bustos | Physical Therapist | 500 Campus Dr, Hancock, MI 49930-1452 | 2018-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437627643 | Karen Byrnes | Registered Nurse | Hancock Va Cboc, 787 Market St. Suite 9, Hancock, MI 49930 | 2018-11-06 |
| 1881117562 | Angelica Monique Nunez | Specialist/Technologist | 601 Quincy St, Hancock, MI 49930 | 2017-07-25 |
| 1831581164 | Superior Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 20075 Third Street, Hancock, MI 49930 | 2015-02-24 |
| 1861703258 | Superior Smiles | Dentist | 1550 West Quincy St, Hancock, MI 49930 | 2010-06-30 |
| 1164633780 | Kathryn Mary Salmi | Counselor | 100 Quincy Street, Hancock, MI 49930 | 2007-05-25 |
| 1093828535 | Mary Katherine Van Camp | Social Worker | 787 Market St., Suites 9 & 10, Hancock, MI 49930 | 2006-08-17 |
| 1083627392 | Kim Kathleen Green | Social Worker | 787 Market Street, Hancock, MI 49930 | 2006-08-15 |
| 1346257672 | James William Sarazin | Dentist | 528 Quincy Street, Hancock, MI 49930 | 2006-08-01 |
| 1114951829 | Patricia J Tikkanen | Social Worker | 200 Michigan St Ste 321, Hancock, MI 49930 | 2006-07-10 |
| 1487639829 | Thomas Collins | Social Worker | 920 Water Street, Hancock, MI 49930 | 2005-12-08 |
| Find all providers in zip 49930 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184786188 | Portage Health Inc | Clinic/Center | 500 Campus Dr, Hancock, MI 49930-1569 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497961 | Saint Marina Home Dialysis LLC | Clinic/Center | 26711 Northwestern Hwy Ste 125, Southfield, MI 48033-2170 | 2020-11-05 |
| 1144820226 | Heritage Home Dialysis LLC | Clinic/Center | 1580 N Leroy St Ste 6, Fenton, MI 48430-2801 | 2020-10-28 |
| 1386262350 | Delta Renal Care Pllc | Clinic/Center | 3981 Elizabeth Ave, Canton, MI 48188-7223 | 2020-07-07 |
| 1457973257 | Fms Owosso, LLC | Clinic/Center | 918 Corunna Ave, Owosso, MI 48867-3768 | 2020-05-14 |
| 1023650926 | Falmont Dialysis LLC | Clinic/Center | 37290 5 Mile Rd, Livonia, MI 48154-1848 | 2019-10-11 |
| 1487112942 | Michigan Dialysis Services, LLC | Clinic/Center | 275 N Canton Center Rd, Canton, MI 48187 | 2019-03-04 |
| 1487123600 | Concerto Michigan LLC | Clinic/Center | 14700 Farmington Rd Ste 108, Livonia, MI 48154-5462 | 2018-11-16 |
| 1245715291 | Brooksprings Dialysis, LLC | Clinic/Center | 2391 Fifteen Mile Rd, Sterling Heights, MI 48310 | 2018-09-26 |
| 1851886592 | Fms Rochester Hills, LLC | Clinic/Center | 26400 W 12 Mile Rd Ste 112, Southfield, MI 48034-1785 | 2018-06-26 |
| 1801399753 | Kasaskia Dialysis LLC | Clinic/Center | 18001 E 10 Mile Rd Ste B, Roseville, MI 48066-3803 | 2018-03-16 |
| Find all providers with the same taxonomy | ||||
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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.