| |
2201 S Getty St Muskegon MI 49444-1207 | |
(231) 767-9806 | |
(231) 737-1808 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 2201 S Getty St, Muskegon, Michigan |
Authorized Official Name and Position | Daniel Oglesby (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2317334800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2201 S Getty St Muskegon MI 49444-1207 Ph: (231) 767-9806 | 2201 S Getty St Muskegon MI 49444-1207 Ph: (231) 767-9806 |
NPI Number | 1255331583 |
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Provider Enumeration Date | 07/28/2005 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 2860384831 |
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Medicare Enrollment ID | O20040325000978 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255331583 | NPI | - | NPPES |
700F11016 | Other | MI | BCBSM GROUP ID NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Michigan) | Primary |
Provider Name | Kathy L Rosema |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689628927 PECOS PAC ID: 1052217593 Enrollment ID: I20031208000460 |
Provider Name | Daniel B Azabache |
---|---|
Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1477535193 PECOS PAC ID: 3870557614 Enrollment ID: I20041112000231 |
Provider Name | Lisa Marshall |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104871169 PECOS PAC ID: 3274533815 Enrollment ID: I20070105000243 |
Provider Name | Casey Lockwood |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1063962447 PECOS PAC ID: 5890045025 Enrollment ID: I20180907002343 |
Provider Name | Zachary Mark Whittle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508492570 PECOS PAC ID: 6103243076 Enrollment ID: I20200825000325 |
Provider Name | Brenna Jean Long |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619589223 PECOS PAC ID: 6507284346 Enrollment ID: I20200910003293 |
Provider Name | Nichole Lamb |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235746389 PECOS PAC ID: 3870913817 Enrollment ID: I20201013003148 |
Provider Name | Teandrea Lynette Mcdaniel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598494734 PECOS PAC ID: 1355722760 Enrollment ID: I20220718000279 |
Provider Name | Paul Michael Bradley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164153672 PECOS PAC ID: 6608258264 Enrollment ID: I20220729001485 |
Provider Name | Shelby Owens |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184252934 PECOS PAC ID: 3476977018 Enrollment ID: I20231024002483 |
Hackley Community Care Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 E Laketon Ave Ste A, Muskegon, MI 49441 Phone: 231-737-1335 | |
Hpcn Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 986 W Norton Ave, Muskegon, MI 49441 Phone: 231-737-2194 Fax: 231-737-4524 | |