UPPER GREAT LAKES FAMILY HEALTH CENTER (NPI# 1295159788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295159788 |
| Entity Type | Organization |
| Organization Name | UPPER GREAT LAKES FAMILY HEALTH CENTER |
| Other Organization Name | MENOMINEE FAMILY HEALTH CENTER |
| Practice Address |
135 E M35 Gwinn MI 49841-9160 |
| Mailing Address |
1110 10th Ave Menominee MI 49858-3058 |
| Practice Telephone | 9063463202 |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2014-02-05 |
| Authorized Official Name | WENDY RAUTIO (CONTROLLER) |
| Authorized Official Telephone | 9063463202 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Menominee Family Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
| 1659889673 | Upper Great Lakes Family Health Center | Psychiatry & Neurology | 965 Fee Rd Rm A229, East Lansing, MI 48824-6410 | 2018-01-11 |
| 1336563832 | Upper Great Lakes Family Health Center | Clinic/Center | 751 S 7th Street, Ontonagon, MI 49953-1450 | 2014-02-05 |
| 1508289273 | Upper Great Lakes Family Health Center | Clinic/Center | 1500 W Ice Lake Road, Iron River, MI 49935-8509 | 2014-01-30 |
| 1740603885 | Upper Great Lakes Family Health Center | Clinic/Center | 945 Ninth Street, Lake Linden, MI 49945-1100 | 2014-01-25 |
| 1811325103 | Upper Great Lakes Family Health Center | Clinic/Center | 600 Macinnes Drive, Houghton, MI 49931-1144 | 2013-10-23 |
| 1700103777 | Upper Great Lakes Family Health Center | Family Medicine | 301 Explorer Street, Gwinn, MI 49841-2813 | 2010-04-29 |
| 1104158690 | Upper Great Lakes Family Health Center | Family Medicine | 135 East M 35, Gwinn, MI 49841-9159 | 2010-02-08 |
| 1396295721 | Upper Great Lakes Family Health Center | Dentist | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2016-10-10 |
| 1164893491 | Upper Great Lakes Family Health Center | Dentist | 301 Explorer St, Gwinn, MI 49841-2813 | 2015-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UPPER GREAT LAKES FAMILY HEALTH CENTER | 506 Campus Dr, Hancock, MI 49930-1569 |
| Street Address |
135 E M35 |
| City | GWINN |
| State | MI |
| Zip Code | 49841-9160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801913082 | Donald Sanford Moisio Jr. | Pharmacist | 135 E M35, Gwinn, MI 49841-9160 | 2007-03-23 |
| 1548792781 | Shayna M Orlich | Nurse Practitioner | 135 E M35, Gwinn, MI 49841 | 2017-03-28 |
| 1861893620 | Emily Starr | Nurse Practitioner | 135 E M35, Gwinn, MI 49841-9160 | 2014-09-11 |
| 1689087959 | Garrett H Green | Counselor | 135 E M35, Gwinn, MI 49841-9160 | 2014-06-04 |
| 1609111749 | Jesse Wayne Heard | Family Medicine | 135 E M35, Gwinn, MI 49841-9160 | 2012-11-30 |
| 1477834695 | Sana Liane Gaffney | Physician Assistant | 135 E M35, Gwinn, MI 49841-9160 | 2011-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457904229 | Gwendolyn Buck Dds Pllc | Clinic/Center | 271 East Sate Highway M-35, Gwinn, MI 49841 | 2019-07-22 |
| 1174905715 | Laurie Robinson | Home Health | 262 Carbon St, Gwinn, MI 49841 | 2015-06-19 |
| 1114183175 | Autumn M Trudeau | Nurse Practitioner | 50 West M-35, Gwinn, MI 49841 | 2008-07-30 |
| 1770755886 | Sands Township | Ambulance | 987 South State Hwy M-553, Gwinn, MI 49841 | 2008-03-28 |
| 1720202146 | Vicki Hyde | Pharmacist | 130 E State Highway M35, Gwinn, MI 49841 | 2007-04-13 |
| 1033125836 | M K Stores Inc | Durable Medical Equipment & Medical Supplies | 130 E State Highway M-35, Gwinn, MI 49841 | 2006-08-01 |
| 1043260995 | Catherine A Kroll | Family Medicine | 135 E. M-35, Gwinn, MI 49841 | 2006-05-11 |
| 1457301319 | Catherine A Kroll, Do,pc | Family Medicine | 135 E. M-35, Gwinn, MI 49841 | 2006-05-11 |
| 1144543745 | Ann Louise Howell | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 132 Provider St, Gwinn, MI 49841-2726 | 2010-03-10 |
| 1700103777 | Upper Great Lakes Family Health Center | Family Medicine | 301 Explorer Street, Gwinn, MI 49841-2813 | 2010-04-29 |
| Find all providers in zip 49841 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1235750571 | Great Lakes Bay Health Centers | Clinic/Center | 2300 Veterans Memorial Pkwy, Saginaw, MI 48601-1268 | 2020-04-28 |
| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
| 1568096923 | Grace Health, Inc. | Clinic/Center | 825 Capital Ave Ne, Battle Creek, MI 49017-5605 | 2020-02-25 |
| 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.