NORTHERN MICHIGAN COSMETIC & RECONSTRUCTIVE SURGERY CENTER P C (NPI# 1255519237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255519237 |
| Entity Type | Organization |
| Organization Name | NORTHERN MICHIGAN COSMETIC & RECONSTRUCTIVE SURGERY CENTER P C |
| Practice Address |
560 W Mitchell St Suite 360 Petoskey MI 49770-2275 |
| Practice Telephone | 2314876070 |
| Practice Fax Number | 2314876073 |
| Mailing Telephone | 2314876070 |
| Mailing Fax Number | 2314876073 |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2011-03-08 |
| Authorized Official Name | DR. WILLIAM J KANE (CEO) |
| Authorized Official Telephone | 2314876070 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
4301069905 | MI | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
4301069604 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
560 W MITCHELL ST SUITE 360 |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770-2275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437156940 | Melanie S Manary | Internal Medicine | 560 W Mitchell St, Ste 300, Petoskey, MI 49770-2278 | 2005-06-30 |
| 1346862455 | Mclaren Central Michigan | Clinic/Center | 560 W Mitchell St, Petoskey, MI 49770-2275 | 2020-05-12 |
| 1841732617 | Dawn Ebersole | Nurse Practitioner | 560 W Mitchell St, Suite M40, Petoskey, MI 49770-2275 | 2016-11-10 |
| 1689025363 | Kasey Peltier | Nurse Practitioner | 560 W Mitchell St, Suite 505, Petoskey, MI 49770-2275 | 2016-06-24 |
| 1912390741 | Twin Oaks Mental Health Center, LLC | Clinic/Center | 560 W Mitchell St, Suite 208, Petoskey, MI 49770-2275 | 2015-03-18 |
| 1053728840 | Kristi Lynn Dipzinski | Nurse Practitioner | 560 W Mitchell St, Suite 300, Petoskey, MI 49770-2275 | 2014-07-14 |
| 1609281401 | Cale M Sebald | Internal Medicine | 560 W Mitchell St, Petoskey, MI 49770-2275 | 2014-07-01 |
| 1942629530 | Robin Brooks | Audiologist | 560 W Mitchell St, Petoskey, MI 49770-2275 | 2014-04-10 |
| 1295074128 | Lindsay Ann Potts | Physician Assistant | 560 W Mitchell St, Suite 505, Petoskey, MI 49770-2275 | 2013-02-13 |
| 1720327695 | Harbor Neurology Plc | Psychiatry & Neurology | 560 W Mitchell St, Suite 350, Petoskey, MI 49770-2275 | 2013-02-12 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 49770 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629528765 | Paragon Health, P.C. | Surgery | 8175 Creekside Dr Ste 100, Portage, MI 49024-5370 | 2016-10-13 |
| 1487091989 | Trevor K O'brien | Surgery | 4110 Copper Ridge Dr Ste 242, Traverse City, MI 49684-6721 | 2013-05-24 |
| 1851689525 | Robert Moore Oneal | Surgery | 501 Onondaga St, Ann Arbor, MI 48104-2606 | 2011-07-15 |
| 1902072952 | Michigan Cosmetic & Reconstructive Surgery Pllc | Surgery | 29110 Inkster Rd, Ste 250, Southfield, MI 48034-1098 | 2008-04-30 |
| 1518184175 | Halil Ibrahim Canter | Surgery | 16001 West 9 Mile Rd., 3 Fl Fischer Ctr Providence Hosp. Craniofacial Inst., Southfield, MI 48075 | 2007-04-18 |
| 1285756148 | Andrea Emma Van Pelt | Surgery | 4070 Lake Drive Se, Suite 202, Grand Rapids, MI 49546 | 2007-04-04 |
| 1083741367 | Kenneth Wolf | Surgery | 1990 Union Lake Rd Ste 200, Commerce Township, MI 48382-2200 | 2007-02-27 |
| 1972630259 | Lauran Bryan | Surgery | 26711 Woodward Ave Ste Ll1, Huntington Woods, MI 48070-1370 | 2007-02-27 |
| 1689761439 | John J Iacobucci | Surgery | 221 Michigan St Ne Ste 300, Grand Rapids, MI 49503-2537 | 2006-10-05 |
| 1710996319 | Ewa D Komorowska-timek | Surgery | 3855 Burton St Se Ste A, Grand Rapids, MI 49546-5816 | 2006-08-05 |
| 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.