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WHITE PINE FAMILY MEDICINE NPI 1740234236


NPI Information

NPI: 1740234236
Provider Name: WHITE PINE FAMILY MEDICINE
Classification: Physician Assistant - 363A00000X
Entity Type: Organization

CLIA Number: 23D0379031

Address:
261 N MAIN
CEDAR SPRINGS, MI
ZIP 49319
Phone: (616) 696-2020
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WHITE PINE FAMILY MEDICINE is a physician assistant in Cedar Springs, MI. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. WHITE PINE FAMILY MEDICINE NPI is 1740234236. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

261 N MAIN
CEDAR SPRINGS, MI
ZIP 49319-709
Phone: (616) 696-2020
Fax: (616) 696-4860

The provider's authorized official is Denise R Wilholt .
The authorized official title is Practice Manager and has the following contact phone number 69166962020.

The CLIA number assigned to this NPI record is 23D0379031 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 8/22/2020.


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
1363A00000XPhysician Assistant5601002704MICHIGANYes

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
14737787MEDICAIDMICHIGAN

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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