MCLAREN NORTHERN MICHIGAN (NPI# 1033289848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033289848 |
| Entity Type | Organization |
| Organization Name | MCLAREN NORTHERN MICHIGAN |
| Other Organization Name | NORTHERN MICHIGAN REGIONAL HOSPITAL |
| Practice Address |
416 Connable Ave Petoskey MI 49770-2212 |
| Practice Telephone | 2314874000 |
| Practice Fax Number | 2314877721 |
| Mailing Telephone | 2314874000 |
| Mailing Fax Number | 2314877721 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2017-12-04 |
| Authorized Official Name | MR. DAVID ZECHMAN (CEO) |
| Authorized Official Telephone | 2314874011 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| Other Name | Type Code |
|---|---|
| Northern Michigan Regional Hospital | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760736094 | Mclaren Northern Michigan | Family Medicine | 416 Connable Ave, Petoskey, MI 49770-2212 | 2012-11-08 |
| 1083771364 | Mclaren Northern Michigan | Pharmacy | 416 Connable Ave, Petoskey, MI 49770-2212 | 2007-01-03 |
| 1881754554 | Mclaren Northern Michigan | Hospitalist | 416 Connable Ave, Petoskey, MI 49770-2212 | 2006-12-11 |
| 1942370754 | Mclaren Northern Michigan | General Acute Care Hospital | 416 Connable Ave, Petoskey, MI 49770-2212 | 2006-11-09 |
| 1386722924 | Mclaren Northern Michigan | General Acute Care Hospital | 820 Arlington Ave, Petoskey, MI 49770-2469 | 2006-11-01 |
| 1992812580 | Mclaren Northern Michigan | General Acute Care Hospital | 416 Connable Ave, Petoskey, MI 49770-2212 | 2006-08-23 |
| Street Address |
416 CONNABLE AVE |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073512687 | Michael A Angileri | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2005-07-15 |
| 1023619483 | Bay Radiation Oncology, Pllc | Radiology | 416 Connable Ave, Petoskey, MI 49770-2212 | 2020-11-03 |
| 1972116895 | Cameron P Burns | Nurse Practitioner | 416 Connable Ave, Petoskey, MI 49770-2212 | 2020-08-29 |
| 1447878566 | Tiffany Hornbeck | Registered Nurse | 416 Connable Ave, Petoskey, MI 49770-2212 | 2020-07-07 |
| 1083231963 | Cory Mills | Registered Nurse | 416 Connable Ave, Petoskey, MI 49770-2212 | 2020-06-26 |
| 1508417031 | Alexander Joseph Perry | Registered Nurse | 416 Connable Ave, Petoskey, MI 49770-2212 | 2019-09-25 |
| 1699332668 | Murphy Gillespie | Nurse Practitioner | 416 Connable Ave, Petoskey, MI 49770-2212 | 2019-05-24 |
| 1407322985 | Shanna Macclaren | Nurse Practitioner | 416 Connable Ave, Petoskey, MI 49770-2212 | 2018-10-22 |
| 1730664186 | Emily Powell | Occupational Therapist | 416 Connable Ave, Petoskey, MI 49770-2212 | 2018-10-02 |
| 1831673458 | Mary Ford | Occupational Therapist | 416 Connable Ave, Petoskey, MI 49770-2212 | 2018-09-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
| 1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
| 1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
| 1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
| 1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
| 1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
| 1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
| 1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
| 1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
| 1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
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| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982983094 | Senior Psychiatric Hospitalists of Mi, Pllc | Psychiatric Unit | 3572 Empire State Dr, Canton, MI 48188-8202 | 2011-08-07 |
| 1841591260 | Growing Counseling Services, LLC | Psychiatric Unit | 446 Tobin Dr, 311, Inkster, MI 48141-3557 | 2010-11-17 |
| 1548426372 | Gloria Carr | Psychiatric Unit | 404 Velvet Ave, Portage, MI 49002-7050 | 2008-07-31 |
| 1356370522 | Advanced Counseling Services | Psychiatric Unit | 6223 N Canton Center Rd, Ste. 210, Canton, MI 48187-2696 | 2006-07-01 |
| 1669431292 | Edward W. Sparrow Hospital Association | Psychiatric Unit | 1210 W. Saginaw Street, Lansing, MI 48912-1999 | 2006-03-22 |
| 1831179837 | Mclaren Greater Lansing | Psychiatric Unit | 2727 S Penn Ave, Lansing, MI 48910-3488 | 2006-01-18 |
| 1003892092 | Ascension Providence Hospital | Psychiatric Unit | 16001 W. 9 Mile Road, Southfield, MI 48075-4818 | 2005-12-21 |
| 1265426704 | Healthsource Saginaw Inc | Psychiatric Unit | 3340 Hospital Rd, Saginaw, MI 48603-9622 | 2005-09-09 |
| 1407480247 | Prime Healthcare Services - Garden City, LLC | Psychiatric Unit | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2020-03-02 |
| 1255748307 | Henry Ford Health System | Psychiatric Unit | 1 Ford Pl, Detroit, MI 48202-3450 | 2014-07-21 |
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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.