UP MEDICAL GROUP - PORTAGE EXPRESS CARE
NPI 1164106910
Clinic/Center - Rural Health in Calumet, MI

Q: What is Portage Physician Practices Inc's NPI number?

The NPI number for Portage Physician Practices Inc is 1164106910. It was assigned to this organization in the NPPES registry on June 12, 2023. The provider is doing business as Up Medical Group - Portage Express Care.

Q: What is Portage Physician Practices Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since June 12, 2023CLIA 23D2077796 · Waiver

56720 CALUMET AVE STE B, CALUMET, MI 49913(906) 481-8952(906) 337-4049 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 12, 2023, Jun 21, 2023, Jun 12, 2023 (3 updates tracked since 2023).

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About Up Medical Group - Portage Express Care NPPES

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

UP MEDICAL GROUP - PORTAGE EXPRESS CARE (NPI 1164106910) is a healthcare organization registered as a rural health in Calumet, Michigan and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through May 14, 2028 and lists Monica Bowman, President, as its authorized official.

NPPES Registry Identity

NPI1164106910

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NamePORTAGE PHYSICIAN PRACTICES INC

Location Address56720 CALUMET AVE STE BCalumet, MI 49913-1967

Mailing Address330 Seven Springs WayBrentwood, TN 37027-5098 · (615) 920-7000

Phone(906) 481-8952

Fax(906) 337-4049

Organization SubpartNo

Authorized OfficialMonica BowmanPresident · (615) 920-7000

Enumeration DateJune 12, 2023

Last NPPES UpdateOctober 12, 20233 updates tracked since enumeration

NPPES CertifiedOctober 12, 2023

✔ NPI 1164106910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

56720 CALUMET AVE STE B, Calumet, MI 49913

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Other Names 1

Doing Business AsUp Medical Group - Portage Express Care

CLIA Laboratory Certificates CMS CLIA

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 23D2077796

Portage Physician Practices, Inc Dba Up Medical Group- Portage Express Care · Calumet, MI

Active · expires May 14, 2028

CLIA Number23D2077796

Laboratory TypePhysician Office

Certificate Effective DateMay 15, 2026

Certificate Expiration DateMay 14, 2028

Laboratory DirectorPetio V. Kotov

Laboratory Phone(906) 483-1435

Laboratory LocationPortage Physician Practices, Inc Dba Up Medical Group- Portage Express Care56720 Calumet Avenue Suite B, Calumet, MI 49913

CLIA data matches this NPI record on: Address Name

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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Portage Physician Practices Inc's NPI number?

The NPI number for Portage Physician Practices Inc is 1164106910. It was assigned to this organization in the NPPES registry on June 12, 2023. The provider is doing business as Up Medical Group - Portage Express Care.

Where is Portage Physician Practices Inc located?

Portage Physician Practices Inc is located at 56720 Calumet Ave Ste B, Calumet, MI 49913. The listed phone number is (906) 481-8952.

What is Portage Physician Practices Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Portage Physician Practices Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2077796) is associated with this NPI, valid through May 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Portage Physician Practices Inc was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.