UPPER GREAT LAKES FAMILY HEALTH CENTER (NPI# 1396295721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396295721 |
| Entity Type | Organization |
| Organization Name | UPPER GREAT LAKES FAMILY HEALTH CENTER |
| Practice Address |
56720 Calumet Ave Calumet MI 49913-1967 |
| Mailing Address |
894 Campus Dr Suite B Hancock MI 49930-1644 |
| Practice Telephone | 9064831177 |
| Practice Fax Number | 9064831188 |
| Mailing Telephone | 9064831445 |
| Mailing Fax Number | 9064831122 |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2017-07-25 |
| Authorized Official Name | MR. DONALD A SIMILA (CEO) |
| Authorized Official Telephone | 9064831325 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| 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 |
| 1164893491 | Upper Great Lakes Family Health Center | Dentist | 301 Explorer St, Gwinn, MI 49841-2813 | 2015-10-13 |
| 1205217239 | Upper Great Lakes Family Health Center | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2015-06-16 |
| 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 |
56720 CALUMET AVE |
| City | CALUMET |
| State | MI |
| Zip Code | 49913-1967 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255410338 | Elizabeth D. Vanlandschoot | Dentist | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2006-11-02 |
| 1407349012 | Alicia Ranae Clark | Dentist | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2018-06-08 |
| 1407347669 | Emily Irene Bushong | Dental Hygienist | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2018-05-23 |
| 1831608629 | Jamie Alea Goff | Dental Hygienist | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2017-09-25 |
| 1114354479 | Upper Great Lakes Family Health Center | Clinic/Center | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2013-10-02 |
| 1316381387 | Adam Girard Frimodig | Family Medicine | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2013-04-22 |
| 1528260171 | Glenda Charlene Reynolds | Dentist | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2007-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386947695 | Sheri L. Giordana | Nurse Practitioner | 205 Osceola St., Aspirus Keweenaw, Laurium, MI 49913 | 2010-12-08 |
| 1700073376 | Body Mechanix Physical Therapy, LLC | Physical Therapist | 56730 Calumet Avenue, Suite M, Calumet, MI 49913 | 2007-09-27 |
| 1568843795 | Wanda Joan Kiiskila | Speech-Language Pathologist | 25770 Elm St, Calumet, MI 49913-1220 | 2015-06-12 |
| 1841464492 | Phoenix House Inc. | Substance Abuse Rehabilitation Facility | 57467 Waterworks St, Calumet, MI 49913-1258 | 2008-04-15 |
| 1225103500 | Aspirus Keweenaw Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 54 2nd St, Laurium, MI 49913-1319 | 2006-11-21 |
| 1417281411 | Superior Pediatrics, Pllc | Pediatrics | 324 5th St, Calumet, MI 49913-1502 | 2009-09-23 |
| 1245462142 | Lisa L Spence | Nurse Practitioner | 324 5th St, Calumet, MI 49913-1502 | 2009-08-12 |
| 1003979501 | Jeffrey Evan Jacobs | Pediatrics | 324 5th St, Calumet, MI 49913-1502 | 2006-12-18 |
| 1548214315 | Keweenaw Home Nursing, Inc. | Hospice Care, Community Based | 311 6th St, Calumet, MI 49913-1507 | 2006-05-19 |
| 1053895870 | Susan Louise Peterson | Physical Therapist | 311 6th St, Calumet, MI 49913-1507 | 2018-09-18 |
| Find all providers in zip 49913 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114354479 | Upper Great Lakes Family Health Center | Clinic/Center | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2013-10-02 |
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| 1831706993 | Family Medical Center of Michigan, Inc | Clinic/Center | 503 Washington St Rm 150, Monroe, MI 48161-1309 | 2020-09-23 |
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| 1700400389 | Northwest Michigan Health Services, Inc. | Clinic/Center | 300 W Broadway Ave Trlr 1, Scottville, MI 49454-1019 | 2020-05-30 |
| 1679195721 | Family Medical Center of Michigan,inc | Clinic/Center | 2740 Collingwood St Ste 100, Detroit, MI 48206-1473 | 2020-05-12 |
| 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.