PORT HURON MERCY FAMILY CARE INC (NPI# 1437163409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437163409 |
| Entity Type | Organization |
| Organization Name | PORT HURON MERCY FAMILY CARE INC |
| Practice Address |
4190 24th Ave Suite 206 Fort Gratiot MI 48059-3882 |
| Mailing Address |
Po Box 610669 Port Huron MI 48061-0669 |
| Practice Telephone | 8102164000 |
| Practice Fax Number | 8102164001 |
| Mailing Telephone | 8109851884 |
| Mailing Fax Number | 8109663025 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2015-07-08 |
| Authorized Official Name | NANCY MASON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8109851884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740686450 | Port Huron Mercy Family Care Inc | Nurse Anesthetist, Certified Registered | 2601 Electric Ave, Port Huron, MI 48060-6587 | 2014-11-06 |
| Street Address |
4190 24TH AVE SUITE 206 |
| City | FORT GRATIOT |
| State | MI |
| Zip Code | 48059-3882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629079611 | Newco Ambulatory Surgery Center, LLP | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2005-08-02 |
| 1518513027 | Aiso Pllc | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2019-08-12 |
| 1588109177 | Heather Kakos | Nurse Anesthetist, Certified Registered | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2017-01-05 |
| 1891246021 | Lake Huron Urgent Care Center, LLC | Internal Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2016-10-24 |
| 1134586852 | Prime Healthcare Services-port Huron, LLC | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2016-01-26 |
| 1598141640 | Port Huron Physicians Medical Group PC | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2015-07-30 |
| 1902281736 | Port Huron Physicians Medical Group PC | Internal Medicine | 4190 24th Ave, Ste 206, Fort Gratiot, MI 48059-3882 | 2015-07-22 |
| 1033505110 | Prime Garden City Medical Group | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2015-04-15 |
| 1003204660 | Beverlie Houser | Nurse Practitioner | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2015-01-06 |
| 1942615414 | Mercy Surgery Care Network | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2014-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679096374 | Rebecca Campau | Registered Nurse | 4985 Lakeshore Rd, Fort Gratiot, MI 48059 | 2017-07-25 |
| 1598175481 | David Kelley Sr. | Pharmacist | 4475 24th Ave., Fort Gratiot, MI 48059 | 2014-05-01 |
| 1316110968 | Apheresis and Transfusion Medicine of Port Huron Pllc | Pathology | 4970 Lakeshore Road, Fort Gratiot, MI 48059 | 2008-04-03 |
| 1275754152 | Jennifer Ann Peyerk | Physical Therapist | 3902 Arlington Ave., Fort Gratiot, MI 48059 | 2007-05-01 |
| 1013097278 | Randy John Plonka | Internal Medicine | 5979 Lakeshore, Ft Gratiot, MI 48059 | 2006-10-16 |
| 1881708428 | John Nathan Seppo | Social Worker | 3847 Pine Grove Avenue, Fort Gratiot, MI 48059 | 2006-08-19 |
| 1396756615 | Blue Water Family Dentistry PC | Dentist | 4044 24th Ave, Fort Gratiot, MI 48059 | 2006-08-11 |
| 1720018823 | Minden City Community Healthcare Outreach | Clinic/Center | 28 Deer Creek Drive, Fort Gratiot, MI 48059 | 2006-07-04 |
| 1982103966 | Luke Michael Privette | Physical Therapist | 4351 24th Ave Ste 1, Fort Gratiot, MI 48059 | 2018-02-06 |
| 1194115352 | Rachel Brooks | Chiropractor | 2844 Krafft Rd, Fort Gratiot, MI 48059 | 2015-01-27 |
| Find all providers in zip 48059 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427693761 | Horizon Family Medicine Pllc | Family Medicine | 3041 Commerce Dr Ste B, Fort Gratiot, MI 48059-3877 | 2019-11-11 |
| 1770126211 | Aleesha Smith | Family Medicine | 4430 Carrigan Rd, Fort Gratiot, MI 48059-2904 | 2019-10-28 |
| 1437125473 | Jude L Stratford | Family Medicine | 3903 Stoney Ridge Dr, Fort Gratiot, MI 48059-3761 | 2006-02-28 |
| 1750379194 | G Blair Dowden IIi | Family Medicine | 4071 24th Ave, Fort Gratiot, MI 48059-3801 | 2005-10-10 |
| 1114222031 | Lighthouse Family Medicine, Pllc | Family Medicine | 4071 24th Ave, Fort Gratiot, MI 48059-3801 | 2011-01-25 |
| 1285749549 | Julie A Boutt | Family Medicine | 4071 24th Ave, Fort Gratiot, MI 48059-3801 | 2006-08-20 |
| 1316914245 | Christopher J Borgiel | Family Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2006-02-28 |
| 1225004252 | Daniel C Souphis | Family Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2006-02-28 |
| 1053399642 | Farrukh Zaman Naqvi | Family Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2006-01-04 |
| 1700862935 | Lavi Rohatgi | Family Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2005-12-20 |
| Find all providers in FORT GRATIOT | ||||
| City | FORT GRATIOT |
| Zip Code | 48059 |
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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.