MUNSON MEDICAL CENTER (NPI# 1083761860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083761860 |
| Entity Type | Organization |
| Organization Name | MUNSON MEDICAL CENTER |
| Other Organization Name | ENDOCRINOLOGY AND METABOLISM |
| Practice Address |
1221 Sixth St Ste 208 Traverse City MI 49684-2360 |
| Mailing Address |
2513 Momentum Pl Chicago IL 60689-5325 |
| Practice Telephone | 2319352045 |
| Practice Fax Number | 2319352046 |
| Mailing Telephone | 2319356080 |
| Mailing Fax Number | 2319356081 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2019-04-22 |
| Authorized Official Name | MARK HEPLER II (CFO) |
| Authorized Official Telephone | 2319355000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS GROUP NUMBER | 0B86016 | 01 |
| MI | BCBS GROUP | 0B81243 | 01 |
| MI | RAILROAD | CB9942 | 01 |
| Other Name | Type Code |
|---|---|
| Endocrinology and Metabolism | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568002004 | Munson Medical Center | Emergency Medicine | 5085 Anna Dr Ste B&c, Traverse City, MI 49684-7475 | 2020-01-13 |
| 1396235610 | Munson Medical Center | Urology | 405 N Division Rd Ste 2, Petoskey, MI 49770-9046 | 2018-05-11 |
| 1376097733 | Munson Medical Center | Radiology | 217 S Madison Avenue, Traverse City, MI 49684-2320 | 2016-08-15 |
| 1699174730 | Munson Medical Center | Physician Assistant | 2513 Momentum Pl, Chicago, IL 60689-5325 | 2014-08-14 |
| 1922030162 | Munson Medical Center | Family Medicine | 1400 Medical Campus Dr, Traverse City, MI 49684-7823 | 2006-07-07 |
| 1003415118 | Munson Medical Center | Physician Assistant | 3074 N Us 31 S, Traverse City, MI 49684-4533 | 2020-10-20 |
| 1326645698 | Munson Medical Center | Psychiatry & Neurology | 1221 Sixth St, Traverse City, MI 49684-2701 | 2020-10-08 |
| 1013535046 | Munson Medical Center | Internal Medicine | 5087 N Royal Dr, Traverse City, MI 49684-6987 | 2020-07-07 |
| 1306302849 | Munson Medical Center | Internal Medicine | 224 Circle Dr, Traverse City, MI 49684-2700 | 2019-02-20 |
| 1073087292 | Munson Medical Center | Registered Nurse | 1105 Sixth St, Traverse City, MI 49684-2345 | 2019-01-22 |
| Street Address |
1221 SIXTH ST STE 208 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-2360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065587 | Cheryl Lynn Devries | Health Educator | 1221 Sixth St Ste 208, Traverse City, MI 49684-2360 | 2019-10-18 |
| 1417590837 | Bridgett Widrig | Health Educator | 1221 Sixth St Ste 208, Traverse City, MI 49684-2360 | 2019-10-18 |
| 1023501699 | Jessica Mastbergen | Nurse Practitioner | 1221 Sixth St Ste 208, Traverse City, MI 49684-2360 | 2018-06-08 |
| 1245522994 | Alison Balmer Quiring | Nurse Practitioner | 1221 Sixth St Ste 208, Traverse City, MI 49684-2360 | 2011-05-12 |
| 1013130525 | Jill Elizabeth Vollbrecht | Internal Medicine | 1221 Sixth St Ste 208, Traverse City, MI 49684-2360 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982798583 | Mary Eleanor Beal | Internal Medicine | 3837 W. Front St, Suite H, Traverse City, MI 49684 | 2006-10-03 |
| 1013130525 | Jill Elizabeth Vollbrecht | Internal Medicine | 1221 Sixth St Ste 208, Traverse City, MI 49684-2360 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851866172 | Grace Endocrine Services Pllc | Internal Medicine | 38864 Hilldale St, Clinton Township, MI 48036-2561 | 2018-10-13 |
| 1245681709 | Winnie Nhan | Internal Medicine | 4000 Ave Maria Dr, Lobby C Suite 1300, Ann Arbor, MI 48105 | 2016-06-27 |
| 1003184748 | Khachorndej Vibhasiri | Internal Medicine | 732 Brookwood Walke, Bloomfield Hills, MI 48304-1900 | 2011-12-08 |
| 1427345065 | Ali Alexandru Achira | Internal Medicine | 4700 Greenfield Rd Ste 2c, Dearborn, MI 48126-4124 | 2011-07-04 |
| 1689979569 | Alzohaili Medical Consultants Md PC | Internal Medicine | 5250 Auto Club Dr Ste 200, Dearborn, MI 48126-2619 | 2011-01-24 |
| 1528377082 | Randall Whitcomb | Internal Medicine | 1527 High Hollow Dr, Ann Arbor, MI 48103-9621 | 2010-10-01 |
| 1639400799 | Kp Anandakrishnan Md PC | Internal Medicine | 5189 Venoy Rd, Wayne, MI 48184-2545 | 2010-01-28 |
| 1194962530 | Richard Michael Mortensen | Internal Medicine | 1301 Catherine St, 7641 Medical Sciences II, Ann Arbor, MI 48109-2026 | 2009-01-07 |
| 1235319872 | Endocrine Hospital Consultants, P.C. | Internal Medicine | 4782 Trailview, West Bloomfield, MI 48322-4572 | 2007-11-12 |
| 1174719025 | Center for Preventive Medicine PC | Internal Medicine | 20870 Mack Ave, Grosse Pointe Woods, MI 48236-1388 | 2007-09-24 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.