20TH STREET CLINIC PC NPI 1578744918

NPI Information

NPI: 1578744918
Provider Name: 20TH STREET CLINIC PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
105 N 20TH ST
BATTLE CREEK, MI
ZIP 49015
Phone: (269) 969-6010
Get Directions

20TH STREET CLINIC PC is a family medicine in Battle Creek, MI. The provider is 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. 20TH STREET CLINIC PC NPI is 1578744918. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

105 N 20TH ST
BATTLE CREEK, MI
ZIP 49015-746
Phone: (269) 969-6010
Fax: (269) 964-8422

The provider's authorized official is Stephen Fedele .
The authorized official title is Owner and has the following contact phone number (269) 969-6010.

The enumeration date for this NPI number is 11/14/2007 and was last updated on 3/27/2013.

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
1	207Q00000X	Family Medicine		5101004673	MICHIGAN	Yes

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
1	111023860	MEDICAID	MICHIGAN
2	CJ8333	OTHER		RR MCR
3	5130499	OTHER		MEDICARE ADVANTAGE
4	E26731	MEDICARE UPIN	MICHIGAN
5	0N44830	MEDICARE PIN	MICHIGAN
6	010057408	OTHER		RR MCR P-TAN
7	464295	OTHER	MICHIGAN	ADVANTRA FREEDOM
8	080A310650	OTHER	MICHIGAN	BCBS

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »