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AUSABLE MEDICAL ASSOCIATES PC NPI 1689697930


NPI Information

NPI: 1689697930
Provider Name: AUSABLE MEDICAL ASSOCIATES, PC

Former Legal Business Name: AUSABLE URGENT CARE PC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 23D1007330

Address:
81 S. I-75 BUSINESS LOOP
GRAYLING, MI
ZIP 49738
Phone: (989) 348-7400
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AUSABLE MEDICAL ASSOCIATES, PC is a family nurse practitioner in Grayling, MI. AUSABLE MEDICAL ASSOCIATES, PC NPI is 1689697930. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Ausable Urgent Care Pc.

The provider's business location address is:

81 S. I-75 BUSINESS LOOP
GRAYLING, MI
ZIP 49738-393
Phone: (989) 348-7400
Fax: (888) 821-5005

The provider's authorized official is Gerald W Gertiser .
The authorized official title is President and has the following contact phone number (989) 348-7400.

The CLIA number assigned to this NPI record is 23D1007330 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/26/2006 and was last updated on 1/27/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineLH010698MICHIGANNo
2363AM0700XPhysician AssistantMedical5601002890MICHIGANNo
3363LF0000XNurse PractitionerFamily4704216377MICHIGANNo
4363LF0000XNurse PractitionerFamily4704159028MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500B010130OTHERMICHIGANNP'S BCBS GROUP #
2104563113MEDICAIDMICHIGAN
3S69656MEDICARE UPINMICHIGAN
4080B010120OTHERMICHIGANMD'S & DO'S BCBS GRP #
5S69656MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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