MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (NPI# 1376657239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376657239 |
| Entity Type | Organization |
| Organization Name | MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL |
| Other Organization Name | OTSEGO EMERGENCY PHYSICIANS |
| Practice Address |
825 N Center Ave Gaylord MI 49735 |
| Mailing Address |
825 N Center Ave Gaylord MI 49735-1592 |
| Practice Telephone | 9897312140 |
| Mailing Telephone | 9897312140 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2018-08-22 |
| Authorized Official Name | THOMAS LEMON (CEO) |
| Authorized Official Telephone | 9897312100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS OF MICHIGAN | 700F960010 | 01 |
| Other Name | Type Code |
|---|---|
| Otsego Emergency Physicians | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124028972 | Munson Healthcare Otsego Memorial Hospital | General Acute Care Hospital | 825 N Center Ave, Gaylord, MI 49735 | 2005-07-22 |
| 1992146807 | Munson Healthcare Otsego Memorial Hospital | General Practice | 2572 N Us Highway 131, Elmira, MI 49730 | 2013-07-09 |
| 1265871339 | Munson Healthcare Otsego Memorial Hospital | General Practice | 2572 N Us Highway 131, Elmira, MI 49730 | 2013-06-21 |
| 1639420557 | Munson Healthcare Otsego Memorial Hospital | General Practice | 3860 S Straits Hwy, Indian River, MI 49749 | 2012-10-02 |
| 1053661231 | Munson Healthcare Otsego Memorial Hospital | General Practice | 3860 S Straits Hwy, Indian River, MI 49749 | 2012-09-14 |
| 1285867838 | Munson Healthcare Otsego Memorial Hospital | General Practice | 3040 Bourn St, Lewiston, MI 49756 | 2009-08-31 |
| 1538328364 | Munson Healthcare Otsego Memorial Hospital | General Practice | 3040 Bourn St, Lewiston, MI 49756 | 2008-06-06 |
| 1164628426 | Munson Healthcare Otsego Memorial Hospital | General Practice | 829 N Center Ave, Gaylord, MI 49735 | 2007-06-25 |
| 1093911364 | Munson Healthcare Otsego Memorial Hospital | General Practice | 1996 Walden Dr, Gaylord, MI 49735 | 2007-06-25 |
| 1447468442 | Munson Healthcare Otsego Memorial Hospital | Physician Assistant | 825 N Center Ave, Gaylord, MI 49735 | 2007-05-21 |
| Street Address |
825 N CENTER AVE |
| City | GAYLORD |
| State | MI |
| Zip Code | 49735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124028972 | Munson Healthcare Otsego Memorial Hospital | General Acute Care Hospital | 825 N Center Ave, Gaylord, MI 49735 | 2005-07-22 |
| 1932721156 | Michelle Reidt | Speech-Language Pathologist | 825 N Center Ave, Gaylord, MI 49735-1592 | 2020-05-11 |
| 1902428121 | Steven Kolb | Occupational Therapist | 825 N Center Ave, Gaylord, MI 49735-1592 | 2020-05-11 |
| 1033691704 | Jonathan Paul Groszek | Occupational Therapist | 825 N Center Ave, Gaylord, MI 49735-1560 | 2018-08-30 |
| 1851873525 | Suzanne Cecile Mueller | Occupational Therapist | 825 N Center Ave, Gaylord, MI 49735-1560 | 2018-08-30 |
| 1467933382 | Stefni Ann Tallent | Occupational Therapist | 825 N Center Ave, Gaylord, MI 49735-1592 | 2018-08-28 |
| 1548741473 | Hannah Stewart | Occupational Therapist | 825 N Center Ave, Gaylord, MI 49735-1592 | 2018-08-28 |
| 1760963664 | Christopher Alan Hope | Occupational Therapist | 825 N Center Ave, Gaylord, MI 49735-1560 | 2018-08-28 |
| 1760985402 | Robert Priestap Sr. | Physical Therapist | 825 N Center Ave, Gaylord, MI 49735-1592 | 2018-03-08 |
| 1548760291 | Kristin Hoeh | Physical Therapist | 825 N Center Ave, Gaylord, MI 49735-1592 | 2018-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447453 | Jenni Kirt | Social Worker | 407 I-75 Bus N, Gaylord, MI 49735 | 2020-11-05 |
| 1922584986 | Patricia Dovalina | Behavior Technician | 2285 Michaywe Dr, Otsego Lake, MI 49735 | 2018-07-12 |
| 1265944581 | James Hulbert | Social Worker | 407 W Main Street, Gaylord, MI 49735 | 2017-10-26 |
| 1548792625 | Somer Lawes | Behavior Technician | 2443 Castlewood Dr, Gaylord, MI 49735 | 2017-03-29 |
| 1922554161 | Mark David Mcpherson | Counselor | 2136 West M-32, Gaylord, MI 49735 | 2016-08-28 |
| 1689063034 | Liza Brandt | Behavioral Analyst | 6748 Colonial Ct, Gaylord, MI 49735 | 2015-01-22 |
| 1942597224 | Visions for Your Community Care Hhc | Home Health | 2365 N Perch Lake Dr, Gaylord, MI 49735 | 2011-07-07 |
| 1073778304 | Julie Lynn Vandusen | Community Health Worker | 5512 Clubhouse Trail, Gaylord, MI 49735 | 2008-07-25 |
| 1073708798 | Alpine Chiropractic, PC | Chiropractor | 529 S. Wisconsin Ave, Gaylord, MI 49735 | 2007-09-06 |
| 1669675567 | Oral and Maxillofacial Surgery Associates | Dentist | 785 E M32, Gaylord, MI 49735 | 2007-06-07 |
| Find all providers in zip 49735 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942375050 | Peter R Handley | Emergency Medicine | 825 N Center Ave, Gaylord, MI 49735-1592 | 2006-11-22 |
| 1528133659 | Martin T Lougen Jr. | Emergency Medicine | 825 N Center Ave, Gaylord, MI 49735-1592 | 2006-11-22 |
| 1790850816 | Jon S Foltz | Emergency Medicine | 825 N Center Ave, Gaylord, MI 49735-1592 | 2006-11-22 |
| 1912959404 | Joy Williams | Emergency Medicine | 825 N Center Ave, Gaylord, MI 49735-1592 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770059529 | Zachary Kenneth Brown | Emergency Medicine | 906 S Crapo St, Mt Pleasant, MI 48858-3662 | 2018-10-19 |
| 1356778286 | Donald Smith Pllc | Emergency Medicine | 1905 N Hammond Lake Dr, Bloomfield Hills, MI 48302-0139 | 2013-10-10 |
| 1346486222 | Flushing Road Urgent Care PC | Emergency Medicine | 1301 Flushing Rd, Flint, MI 48504-4710 | 2008-12-26 |
| 1184897209 | Donnell Stephen Newman Jr. | Emergency Medicine | 1460 Lakepointe St, Grosse Pointe Park, MI 48230-1016 | 2008-04-09 |
| 1205849866 | Daryl D Wisdom | Emergency Medicine | 10015 Cascade Rd Se, Lowell, MI 49331-9529 | 2006-08-14 |
| 1134131683 | Rick L Holland | Emergency Medicine | 8333 Felch Ave, Zeeland, MI 49464 | 2006-08-13 |
| 1760493472 | Katherine J Pitus | Emergency Medicine | 118000 E Twelve Mile Rd, Er Department, Warren, MI 48093 | 2006-08-10 |
| 1952319881 | Robert Prodinger | Emergency Medicine | 9825 W Gull Lake Dr, Richland, MI 49083-9543 | 2006-08-04 |
| 1164436671 | James Barry Nolin | Emergency Medicine | 1805 Wild Dr, Richland, MI 49083-9361 | 2006-07-28 |
| 1518987072 | Trace Dotson | Emergency Medicine | 118000 E Twelve Mile Road, Er Department, Warren, MI 48093 | 2006-07-20 |
| 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.