PRIME HEALTHCARE SERVICES-PORT HURON LLC
NPI 1912525361
Nurse Anesthetist, Certified Registered in Port Huron, MI
About Prime Healthcare Services-port Huron Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIME HEALTHCARE SERVICES-PORT HURON LLC (NPI 1912525361), doing business as Lake Huron Medical Center, is a healthcare organization registered as a nurse anesthetist, certified registered in Port Huron, Michigan and active in the NPI registry since July 2020. The organization maintains a secondary practice location in Fort Gratiot and lists Christopher Scott Fulks, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prime Healthcare Services-port Huron Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
24Medicare enrollment records show 24 clinicians reassign Medicare billing to Prime Healthcare Services-Port Huron LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 12 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 2
Nearest to this location (20)
See all 24Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Prime Healthcare Services-Port Huron LLC's NPI number?
The NPI number for Prime Healthcare Services-Port Huron LLC is 1912525361. It was assigned to this organization in the NPPES registry on July 13, 2020. The provider is doing business as Lake Huron Medical Center.
Where is Prime Healthcare Services-Port Huron LLC located?
Prime Healthcare Services-Port Huron LLC is located at 2601 Electric Ave, Port Huron, MI 48060. The listed phone number is (810) 216-1500.
What is Prime Healthcare Services-Port Huron LLC's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Prime Healthcare Services-Port Huron LLC enrolled in Medicare?
Yes. Prime Healthcare Services-Port Huron LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prime Healthcare Services-Port Huron LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 24 clinicians in 2 Medicare specialties reassign their Medicare billing to Prime Healthcare Services-Port Huron LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Certified Registered Nurse Anesthetist (CRNA) (19) and Anesthesiology (5). Of these, 4 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Prime Healthcare Services-Port Huron LLC accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Prime Healthcare Services-Port Huron LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Prime Healthcare Services-Port Huron LLC was last updated on July 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Prime Healthcare Services-Port Huron Llc · NPI 1912525361
Nurse Anesthetist, Certified Registered organization in Port Huron, Michigan. Organization record, active in the CMS NPPES registry since July 13, 2020.
## Identity
- **NPI:** 1912525361 (Entity type: Organization)
- **Enumerated:** July 13, 2020
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **Also known as:** Lake Huron Medical Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Christopher Fulks, CFO
## Practice location
- **Address:** 2601 ELECTRIC AVE, Port Huron, MI 48060-6587
- **Phone:** (810) 216-1500
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 24 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Certified Registered Nurse Anesthetist (CRNA) (19), Anesthesiology (5); 4 practice at this address and 12 within 10 miles; [full list](https://npiprofile.com/npi/1912525361/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 13, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1912525361) · Data from the CMS NPPES public registry.