INDIGO HOSPITAL MEDICINE - MANISTEE, PLC (NPI# 1124415666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124415666 |
| Entity Type | Organization |
| Organization Name | INDIGO HOSPITAL MEDICINE - MANISTEE, PLC |
| Practice Address |
1400 E Parkdale Ave Manistee MI 49660-9776 |
| Mailing Address |
10850 E Traverse Hwy Ste 4400 Traverse City MI 49684-1364 |
| Practice Telephone | 2313466807 |
| Mailing Telephone | 2313466800 |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-10-12 |
| Authorized Official Name | ANNE E MCMORROW (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 2313466807 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
1400 E PARKDALE AVE |
| City | MANISTEE |
| State | MI |
| Zip Code | 49660-9776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114901576 | Brian Jay Mccomb | Family Medicine | 1400 E Parkdale Ave, Suite #4, Manistee, MI 49660-9776 | 2005-11-30 |
| 1104461755 | Munson Home Services | Durable Medical Equipment & Medical Supplies | 1400 E Parkdale Ave, Manistee, MI 49660-9776 | 2019-11-07 |
| 1891112819 | Danielle Marie Olson-basora | Family Medicine | 1400 E Parkdale Ave, Manistee, MI 49660-9776 | 2014-03-27 |
| 1881021095 | Munson Healthcare Manistee Hospital | Clinic/Center | 1400 E Parkdale Ave, Manistee, MI 49660-9776 | 2013-10-02 |
| 1760700363 | Katie J Dye | Physician Assistant | 1400 E Parkdale Ave, Suite 3, Manistee, MI 49660-9776 | 2010-05-07 |
| 1700809282 | Donald S. Miller | Dentist | 1400 E Parkdale Ave, Suite #2, Manistee, MI 49660-9776 | 2006-07-25 |
| 1598782443 | William Weiner | Internal Medicine | 1400 E Parkdale Ave, Ste: 4, Manistee, MI 49660-9776 | 2006-07-16 |
| 1548207400 | James Christopher Buswinka Do Plc | Psychiatry & Neurology | 1400 E Parkdale Ave, Manistee, MI 49660-9776 | 2006-06-01 |
| 1396729448 | James Christopher Buswinka | Psychiatry & Neurology | 1400 E Parkdale Ave, Suite 3, Manistee, MI 49660-9776 | 2005-12-02 |
| 1548244916 | Brian J Mccomb Do Pllc | Family Medicine | 1400 E Parkdale Ave, Suite #1, Manistee, MI 49660-9776 | 2005-11-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083192306 | Margaret R Batzer | Acupuncturist | 352 1st St, Manistee, MI 49660 | 2018-07-30 |
| 1821590373 | Esther Sigurdardottir | Physical Therapist | 1465 E. Parkdale Av, Manistee, MI 49660 | 2018-03-01 |
| 1104328657 | Bryan Keith Kidd | Physical Therapist | 1465 Parkdale Avenue, Manistee, MI 49660 | 2018-03-01 |
| 1790153799 | Deborah Ann Brandt | Registered Nurse | 318 River Street, Friends Who Care, Manistee, MI 49660 | 2015-09-08 |
| 1265811624 | Joyce Eileen Copeland | Assisted Living Facility | 3644 Chippewa Hwy, Manistee, MI 49660 | 2015-05-19 |
| 1275927931 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 16 Caberfae Hwy, Manistee, MI 49660 | 2015-03-20 |
| 1518244912 | Mara Lane Mckinley | Nurse Practitioner | 1465 E. Parkdale Ave3., Manistee, MICHIGAN 49660 | 2011-11-14 |
| 1477749406 | Catherine Imelda Oertel | Social Worker | 2198 Us 31 South, Manistee, MI 49660 | 2007-09-24 |
| 1811109051 | Goodwill Optical Inc | Optometrist | 282 12th St, Manistee, MI 49660 | 2007-05-03 |
| 1144364381 | Layne Christopher Godzina | Dentist | 422 First Street, Manistee, MI 49660 | 2007-02-19 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1174605653 | Ryan A Sullivan | Internal Medicine | 2198 Us Highway 31 S, Manistee, MI 49660-9618 | 2006-10-20 |
| 1427160068 | Raymond Edward Schmoke | Internal Medicine | 1806 East Parkdale Avenue, Manistee, MI 49660 | 2006-08-31 |
| 1750638516 | Charles Jay Vandenberg Iv | Internal Medicine | 1391 E Parkdale Ave, Manistee, MI 49660-9352 | 2012-08-12 |
| 1346437316 | Raymond E. F. Schmoke, Md. P.C. | Internal Medicine | 1806 East Parkdale Avenue, Manistee, MI 49660 | 2007-10-03 |
| 1942407416 | Steven R. Frelier Md PC | Internal Medicine | 1391 E Parkdale Ave, Suite 101, Manistee, MI 49660-9352 | 2007-06-28 |
| 1538361134 | Theodore N Batzer Mdpc | Internal Medicine | 1391 E Parkdale Ave, Manistee, MI 49660-9352 | 2007-06-05 |
| 1518180280 | Amy L Beeman Do Pllc | Internal Medicine | 1293 E Parkdale Ave, Suite 1200d, Manistee, MI 49660-8904 | 2007-04-11 |
| 1629165063 | Ryan A Sullivan, Md PC | Internal Medicine | 1391 E Parkdale Ave, Manistee, MI 49660-9352 | 2006-10-06 |
| 1598782443 | William Weiner | Internal Medicine | 1400 E Parkdale Ave, Ste: 4, Manistee, MI 49660-9776 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910687 | Berry Johnson Health Pllc | Internal Medicine | 30123 Rock Creek Dr, Southfield, MI 48076-5358 | 2020-10-24 |
| 1386243178 | Hoover Internal Medicine Pllc | Internal Medicine | 4067 Georgia St, Hamtramck, MI 48212 | 2020-10-22 |
| 1790399798 | Enhua Wang | Internal Medicine | 1215 E Michigan Ave Ste 500, Lansing, MI 48912-1811 | 2020-09-07 |
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 1568074375 | Mohammad Nadeemullah Pllc | Internal Medicine | 5400 Waldenhill Ct, Superior Twp, MI 48198-9654 | 2020-08-21 |
| 1356953723 | Eager Internal Medicine, Pllc | Internal Medicine | 720 N Lapeer Rd Ste 101, Lake Orion, MI 48362-4011 | 2020-08-18 |
| 1144838335 | Ranim Chamseddin | Internal Medicine | 3200 Five Points Dr Unit 110, Auburn Hills, MI 48326-2372 | 2020-07-14 |
| 1407474562 | Pravalika Rudraraju | Internal Medicine | 6245 Inkster Rd Dept Of, Garden City, MI 48135-4001 | 2020-07-06 |
| 1780200469 | Abed L Dabaja | Internal Medicine | 6245 Inkster Rd # Gme, Garden City, MI 48135-4001 | 2020-06-18 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
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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.