KALAMAZOO ENDO CENTER LLC – NPI #1811933179
Clinic/Center

KALAMAZOO ENDO CENTER LLC is an AHC clinic located in PORTAGE, MI. NPPES has assigned the NPI number 1811933179 to KALAMAZOO ENDO CENTER LLC on June 22, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on Nov 04, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KALAMAZOO ENDO CENTER LLC below.

NPI Profile for
KALAMAZOO ENDO CENTER LLC

NPI Number
1811933179
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
KALAMAZOO ENDO CENTER LLC
Primary location
3300 COOLEY COURT
PORTAGE, MI 49024
Phone: (269) 321-3390 Fax: (269) 321-3392
Mailing address
3300 COOLEY CT
PORTAGE, MI 49024-7430
Phone: (269) 321-3390 Fax: (269) 321-3392
Organization Subpart
No
Authorized Official
JILL ULBERG
ADMINISTRATOR
Phone: (269) 321-3390
Updated
Certification Date
Nov 04, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for KALAMAZOO ENDO CENTER LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherAAAHC ORGANIZATION NUMBERMI70733
otherBCBSMI40006
otherCLIA CERTIFICATE WAIVER23D1045430
otherSTATE LICENSEMI396833
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)
MI 396833

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.