SOUTHWESTERN MICHIGAN EMERGENCY SERVICES, PC (NPI# 1033396023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033396023 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN MICHIGAN EMERGENCY SERVICES, PC |
| Practice Address |
408 Hazen St Emergency Department Paw Paw MI 49079-1019 |
| Mailing Address |
8993 Reliable Parkway Chicago IL 60686-0001 |
| Practice Telephone | 2693433900 |
| Mailing Telephone | 8668987139 |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |
| Authorized Official Name | MR. JAMES DEMOSS (PRESIDENT) |
| Authorized Official Telephone | 2693433900 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811174899 | Southwestern Michigan Emergency Services, PC | Emergency Medicine | 601 John St, Emergency Department, Kalamazoo, MI 49007-5341 | 2008-01-22 |
| 1013021310 | Southwestern Michigan Emergency Services, PC | Emergency Medicine | 125 S Kalamazoo Mall, Suite 204, Kalamazoo, MI 49007-4832 | 2006-08-17 |
| Street Address |
408 HAZEN ST EMERGENCY DEPARTMENT |
| City | PAW PAW |
| State | MI |
| Zip Code | 49079-1019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992741599 | John F Boothby | Nurse Anesthetist, Certified Registered | 408 Hazen St, Paw Paw, MI 49079-1019 | 2006-06-21 |
| 1376195032 | Erik Matheny | Physical Therapist | 408 Hazen St, Paw Paw, MI 49079-1019 | 2019-07-12 |
| 1164645388 | Bryan Shawn Parks | Nurse Anesthetist, Certified Registered | 408 Hazen St, Paw Paw, MI 49079-1019 | 2007-04-10 |
| 1750482444 | Bronson Lakeview Hospital | Psychiatric Unit | 408 Hazen St, Paw Paw, MI 49079-1019 | 2006-09-26 |
| 1962508259 | Bronson Lakeview Hospital | General Acute Care Hospital | 408 Hazen St, Paw Paw, MI 49079-1019 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1346775269 | Timothy Adli Kanaan | Counselor | 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 | 2017-04-28 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1942401047 | Jenny Adina Grunberg | Dentist | 54055 County Rd 653, Paw Paw, MI 49079 | 2007-05-29 |
| 1912058918 | David James Potts | Psychologist | 181 West Michigan Ave Suite 3, Mapleview Consultation Center P.c, Paw Paw, MI 49079 | 2007-01-16 |
| 1760438378 | Starhealth Multi-specialty Group, P.C. Pharmacy | Pharmacist | 451 Health Parkway, Paw Paw, MI 49079 | 2006-05-25 |
| 1528029568 | Jayantilal J Bathani | Pediatrics | 505 Hazen St, Ste 203, Paw Paw, MI 49079 | 2006-03-29 |
| 1548231202 | Gregory Cassidy | Physician Assistant | 125 N Kalamazoo St, #82, Paw Paw, MI 49079 | 2006-01-31 |
| 1649782418 | Amber Bemis | Occupational Therapy Assistant | 801 Hazen Street, Suite C, Paw Paw, MI 49079 | 2017-11-01 |
| 1073047122 | Theresa Arnold | Social Worker | 181 W Michigan Ave Ste 3, Paw Paw, MI 49079 | 2017-04-15 |
| Find all providers in zip 49079 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770059529 | Zachary Kenneth Brown | Emergency Medicine | 906 S Crapo St, Mt Pleasant, MI 48858-3662 | 2018-10-19 |
| 1356778286 | Donald Smith Pllc | Emergency Medicine | 1905 N Hammond Lake Dr, Bloomfield Hills, MI 48302-0139 | 2013-10-10 |
| 1346486222 | Flushing Road Urgent Care PC | Emergency Medicine | 1301 Flushing Rd, Flint, MI 48504-4710 | 2008-12-26 |
| 1184897209 | Donnell Stephen Newman Jr. | Emergency Medicine | 1460 Lakepointe St, Grosse Pointe Park, MI 48230-1016 | 2008-04-09 |
| 1205849866 | Daryl D Wisdom | Emergency Medicine | 10015 Cascade Rd Se, Lowell, MI 49331-9529 | 2006-08-14 |
| 1134131683 | Rick L Holland | Emergency Medicine | 8333 Felch Ave, Zeeland, MI 49464 | 2006-08-13 |
| 1760493472 | Katherine J Pitus | Emergency Medicine | 118000 E Twelve Mile Rd, Er Department, Warren, MI 48093 | 2006-08-10 |
| 1952319881 | Robert Prodinger | Emergency Medicine | 9825 W Gull Lake Dr, Richland, MI 49083-9543 | 2006-08-04 |
| 1164436671 | James Barry Nolin | Emergency Medicine | 1805 Wild Dr, Richland, MI 49083-9361 | 2006-07-28 |
| 1518987072 | Trace Dotson | Emergency Medicine | 118000 E Twelve Mile Road, Er Department, Warren, MI 48093 | 2006-07-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.