SOMA MEDICAL CLINIC, LLC (NPI# 1952494353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952494353 |
| Entity Type | Organization |
| Organization Name | SOMA MEDICAL CLINIC, LLC |
| Practice Address |
955 S Bailey Ave South Haven MI 49090-6743 |
| Practice Telephone | 2696375271 |
| Practice Fax Number | 2696392919 |
| Mailing Telephone | 2696375271 |
| Mailing Fax Number | 2696392919 |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2013-04-22 |
| Authorized Official Name | ANGIE OETMAN (MEDICAL STAFF COORDINATOR) |
| Authorized Official Telephone | 2696392807 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
042007627 | IL | Ambulatory Health Care Facilities |
| Y | 282N00000X | General Acute Care Hospital | 4301102383 | MI | Hospitals |
| Street Address |
955 S BAILEY AVE |
| City | SOUTH HAVEN |
| State | MI |
| Zip Code | 49090-6743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548256449 | William Dean Gilmer | Nurse Anesthetist, Certified Registered | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2005-09-26 |
| 1184245342 | Lynn Yvette Sharpe | Physical Therapist | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2020-04-29 |
| 1174142442 | Kim House | Dietitian, Registered | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2020-04-15 |
| 1447803366 | Josiah Griffore | Physical Therapist | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2019-07-19 |
| 1639730948 | Scott Eric Smith | Occupational Therapist | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2019-06-26 |
| 1083114532 | Sarah R Rucano | Specialist/Technologist | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2018-02-20 |
| 1356718761 | South Haven Community Health System | General Acute Care Hospital | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2015-09-01 |
| 1215312202 | Katrina Nichole Barrett | Nurse Practitioner | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2015-07-20 |
| 1841698917 | Christopher Wendling | Specialist/Technologist | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2014-12-05 |
| 1952742603 | Andrew Josiah Rife | Physician Assistant | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2013-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295234490 | Katara Therapy, LLC | Social Worker | 13560 76th Street, Suite 3, South Haven, MI 49090 | 2018-02-03 |
| 1487022091 | Kevin E. Ferrell | Physician Assistant | 955 S. Bailey Avenue, South Haven, MI 49090 | 2015-09-14 |
| 1942638002 | Birdie Farley | Chore Provider | 26725 M-140 Hwy, South Haven, MI 49090 | 2013-10-28 |
| 1730514910 | Rebecca A. Bennett | Counselor | 1675 Phoenix Road, Suite 9, South Haven, MI 49090 | 2013-09-06 |
| 1902149818 | Bronson South Haven Hospital | Emergency Medicine | 970 S Bailey Ave, South Haven, MI 49090 | 2013-03-28 |
| 1265629927 | Cecilia Liz Vives Vasquez | Physical Therapist | 23701 Red Arrow Hwy, Mattawan, MI 49090 | 2007-09-26 |
| 1518089788 | Donald Jam,es Buckley | Pharmacist | 955 S Bailey, South Haven, MI 49090 | 2007-04-06 |
| 1366568966 | Norman M Maly | Dentist | 05055 Blue Star Hwy, South Haven, MI 49090 | 2007-03-22 |
| 1639264062 | Deborah Sue Distefano | Pharmacy Technician | 512 Phoenix Street, South Haven, MI 49090 | 2006-10-03 |
| 1053357897 | Stephen Earl Tolen | Chiropractor | 325 Superior St., South Haven, MI 49090 | 2006-06-21 |
| Find all providers in zip 49090 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356718761 | South Haven Community Health System | General Acute Care Hospital | 955 S Bailey Ave, South Haven, MI 49090-6743 | 2015-09-01 |
| 1346275856 | Bronson South Haven Hospital | General Acute Care Hospital | 955 S Bailey Ave, South Haven, MI 49090-9701 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740899194 | Ascension Michigan Employer Solutions LLC | General Acute Care Hospital | 5555 Conner St Ste 2818, Detroit, MI 48213-3448 | 2020-07-30 |
| 1295246106 | Henry Ford Health Sytems | General Acute Care Hospital | 18800 Hubbard Dr, Dearborn, MI 48126-4305 | 2017-10-18 |
| 1972043081 | Melissa Kovaleski | General Acute Care Hospital | 1029 Chestnut Ln, South Lyon, MI 48178-1896 | 2017-03-08 |
| 1699125922 | Sarah Finlay | General Acute Care Hospital | 5333 Mcauley Dr Ste 40001, Ypsilanti, MI 48197-1014 | 2016-06-17 |
| 1528412517 | Bess Marie Connors | General Acute Care Hospital | 1506 Pontiac Trl, Ann Arbor, MI 48105-1719 | 2016-04-16 |
| 1093198624 | The Memorial Hospital | General Acute Care Hospital | 826 W King St # 1-117, Owosso, MI 48867-2120 | 2015-07-01 |
| 1326428285 | Ipc Hospitalist Company | General Acute Care Hospital | 1628 Huntwood Park Ct, West Bloomfield, MI 48324-3998 | 2015-06-05 |
| 1689088304 | Florida Hospital | General Acute Care Hospital | 7922 Barrie, Dearborn, MI 48126 | 2014-06-20 |
| 1720491954 | University of Michigan | General Acute Care Hospital | 1515 E. Hospital Drive, Towsley Center, 1218, Spc 5222, Ann Arbor, MI 48109-5222 | 2014-06-05 |
| 1366866956 | Bronson Methodist Hospital | General Acute Care Hospital | 601 John St Ste M-425, Kalamazoo, MI 49007-5354 | 2014-02-18 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HAVEN |
| Zip Code | 49090 |
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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.