MERCY PHYSICIAN NETWORK
Complete NPI Record 1023056744
Family Medicine in Muskegon, MI
Active since June 03, 2006
Complete NPI Dataset
This page contains the complete raw NPPES record for Mercy Physician Network (NPI 1023056744), a family medicine organization in Muskegon, MI. All 49 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1023056744 Field 1/49
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/49
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/49
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: MERCY PHYSICIAN NETWORK Field 4/49
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: Not available Field 5/49
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 6 Field 6/49
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: PO BOX 1848 Field 7/49
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: MUSKEGON Field 8/49
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: MI Field 9/49
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 494431848 Field 10/49
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/49
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 2316722120 Field 12/49
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 2317285981 Field 13/49
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 2006 HOLTON RD Field 14/49
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: MUSKEGON Field 15/49
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: MI Field 16/49
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 49445 Field 17/49
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/49
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 2316723333 Field 19/49
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: GUSHO Field 22/49
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: MICHAEL Field 23/49
- The first name of the authorized official.
- Authorized Official Title or Position: CHIEF FINANCIAL OFFICER Field 24/49
- The title or position of the authorized official.
- Authorized Official Telephone Number: 7343980642 Field 25/49
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 207R00000X Field 26/49
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number State Code 1: MI Field 27/49
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 28/49
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 363A00000X Field 29/49
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number State Code 2: MI Field 30/49
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 31/49
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 363L00000X Field 32/49
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number State Code 3: MI Field 33/49
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 3: N Field 34/49
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 4: 207RG0300X Field 35/49
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number State Code 4: MI Field 36/49
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 4: N Field 37/49
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 5: 207Q00000X Field 38/49
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number State Code 5: MI Field 39/49
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 5: Y Field 40/49
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: Y Field 41/49
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Parent Organization LBN: MERCY HEALTH PARTNERS Field 42/49
- The Legal Business Name (LBN) of the parent organization, if the provider is a subpart of a larger entity. This field identifies the official registered name of the parent company or organization under which the provider operates.
- Parent Organization TIN: Not available Field 43/49
- The Taxpayer Identification Number (TIN) of the parent organization, provided when the provider is a subpart of a larger entity. This field identifies the federal tax ID used by the parent organization for official and billing purposes.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 44/49
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP Field 45/49
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 3: 193200000X MULTI-SPECIALTY GROUP Field 46/49
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 4: 193200000X MULTI-SPECIALTY GROUP Field 47/49
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 5: 193200000X MULTI-SPECIALTY GROUP Field 48/49
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Other Organization Names 1
Additional business and trade names this provider has on file with the NPPES registry.
Mercy General Physician Network Former Legal Business Name
Name 1/1Former Legal Business Name: A previous registered legal name once used by an organization that has since been changed or retired.
Secondary Practice Locations 20
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
3587 Henry St Ste 200
Location 1/20Norton Shores, MI 49441-6732 · Phone (231) 672-6700 · Fax (231) 672-6749
1675 Leahy St Ste 301A
Location 2/20Muskegon, MI 49442-5543 · Phone (231) 728-5000 · Fax (231) 728-5041
6401 Prairie St Ste 2800
Location 3/20Norton Shores, MI 49444-7841 · Phone (231) 724-7848 · Fax (231) 724-7850
2006 Holton Rd
Location 4/20Muskegon, MI 49445-1505 · Phone (231) 672-3333 · Fax (231) 672-6520
1150 E Sherman Blvd Ste 1175
Location 5/20Muskegon, MI 49444-1885 · Phone (231) 672-6740 · Fax (231) 672-6749
3443 Farr Rd
Location 6/20Fruitport, MI 49415-8779 · Phone (231) 672-2900 · Fax (231) 672-2901
1310 Wisconsin St Ste 301
Location 7/20Grand Haven, MI 49417-2472 · Phone (616) 847-1860 · Fax (616) 844-4527
1310 Wisconsin St Ste 100
Location 8/20Grand Haven, MI 49417-2472 · Phone (616) 844-4701 · Fax (616) 847-1863
1223 Mercy Dr
Location 9/20Muskegon, MI 49444-1829 · Phone (231) 672-3177 · Fax (231) 672-3178
221 S Quarterline Rd
Location 10/20Muskegon, MI 49442-1432 · Phone (231) 672-7180 · Fax (231) 672-7181
6401 Prairie St Ste 2600
Location 11/20Norton Shores, MI 49444-7842 · Phone (231) 727-7900 · Fax (231) 727-7914
15151 Stanton St
Location 12/20West Olive, MI 49460-8543 · Phone (616) 296-1020 · Fax (616) 296-1030
1778 Sanford St
Location 13/20Muskegon, MI 49441-2537 · Phone (231) 727-4444 · Fax (231) 727-4451
601 W Savidge St
Location 14/20Spring Lake, MI 49456-1620 · Phone (231) 672-3100 · Fax (231) 672-3102
1150 E Sherman Blvd Ste 1100
Location 15/20Muskegon, MI 49444-4607 · Phone (231) 672-2203 · Fax (231) 672-2992
1675 Leahy St Ste 201A
Location 16/20Muskegon, MI 49442-5542 · Phone (231) 672-7800 · Fax (231) 672-7801
6207 Harvey St Ste A
Location 17/20Norton Shores, MI 49444-7861 · Phone (231) 672-2230 · Fax (231) 672-2231
3535 Park St Ste 110
Location 18/20Norton Shores, MI 49444-3795 · Phone (231) 672-3155 · Fax (231) 672-3157
1909 Ruddiman Dr
Location 19/20Muskegon, MI 49445-3147 · Phone (231) 672-7466 · Fax (231) 744-9027
1310 Wisconsin St Ste 103
Location 20/20Grand Haven, MI 49417-2472 · Phone (616) 846-2640 · Fax (616) 846-3100
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