MCLAREN THUMB REGION - PORT AUSTIN CAMPUS
NPI 1083772826
Family Medicine in Bad Axe, MI

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since December 05, 2006

1100 S VAN DYKE RD, BAD AXE, MI 48413(989) 269-9521(989) 269-5260 Get Directions Write a Review

NPPES record last updated: March 28, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mclaren Thumb Region - Port Austin Campus NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MCLAREN THUMB REGION - PORT AUSTIN CAMPUS (NPI 1083772826) is a healthcare organization registered as a family medicine in Bad Axe, Michigan and active in the NPI registry since December 2006. The organization lists Michael Eric Johnston, President & Ceo, as its authorized official.

NPPES Registry Identity

NPI1083772826

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameHURON MEMORIAL HOSPITAL

Location Address1100 S VAN DYKE RDBad Axe, MI 48413-9615

Mailing Address1100 S Van Dyke RdBad Axe, MI 48413-9615 · (989) 269-9521 · Fax (989) 269-5260

Phone(989) 269-9521

Fax(989) 269-5260

Organization SubpartYes

Authorized OfficialMichael Eric JohnstonPresident & Ceo · (989) 803-7127

Enumeration DateDecember 5, 2006

Last NPPES UpdateMarch 28, 2019

✔ NPI 1083772826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · RL040876

Definition

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.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License RD002414 (MI)

1100 S VAN DYKE RD, Bad Axe, MI 48413

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Other Names 1

Doing Business AsMclaren Thumb Region - Port Austin Campus

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2005419

Thumb Convenient Care Clinic · Bad Axe, MI

Active · expires Mar 31, 2027

CLIA Number23D2005419

Laboratory TypeRural Health Clinic

Certificate Effective DateApril 1, 2025

Certificate Expiration DateMarch 31, 2027

Laboratory DirectorOlivia Thiel

Laboratory Phone(989) 269-5152

Laboratory LocationThumb Convenient Care Clinic1060 S Van Dyke Road Suite 600, Bad Axe, MI 48413

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D1006421

Mclaren Thumb 1011 Building · Bad Axe, MI

Active · expires Nov 14, 2026

CLIA Number23D1006421

Laboratory TypeRural Health Clinic

Certificate Effective DateNovember 15, 2024

Certificate Expiration DateNovember 14, 2026

Laboratory DirectorOlivia Thiel

Laboratory Phone(989) 269-5268

Laboratory LocationMclaren Thumb 1011 Building1011 S Van Dyke Road, Bad Axe, MI 48413

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAJALAKSHMI A. AGRAWAL, MD, PC

Anesthesiology