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ASCENSION MEDICAL GROUP PROMED NPI 1720009954


NPI Information

NPI: 1720009954
Provider Name: ASCENSION MEDICAL GROUP PROMED
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 23D0376741

Address:
1717 SHAFFER ST
STE 124
KALAMAZOO, MI
ZIP 49048
Phone: (269) 344-5552
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ASCENSION MEDICAL GROUP PROMED is an internal medicine in Kalamazoo, MI. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. ASCENSION MEDICAL GROUP PROMED NPI is 1720009954. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1717 SHAFFER ST
STE 124
KALAMAZOO, MI
ZIP 49048-647
Phone: (269) 344-5552

The provider's authorized official is Marina Houghton .
The authorized official title is Cfo and has the following contact phone number (269) 226-4800.

The CLIA number assigned to this NPI record is 23D0376741 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 12/30/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QH0002XFamily MedicineHospice and Palliative MedicineMICHIGANNo
2207RC0000XInternal MedicineCardiovascular DiseaseNo
3208100000XPhysical Medicine & RehabilitationNo
42085N0700XRadiologyNeuroradiologyNo
5207RP1001XInternal MedicinePulmonary DiseaseNo
6207RR0500XInternal MedicineRheumatologyNo
72080N0001XPediatricsNeonatal-Perinatal MedicineNo
8207RG0100XInternal MedicineGastroenterologyNo
9207RH0002XInternal MedicineHospice and Palliative MedicineNo
10207R00000XInternal MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1700C910600OTHERBCBSM

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: 4/28/2024

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