MICHIGAN STATE UNIVERSITY (NPI# 1467535211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467535211 |
| Entity Type | Organization |
| Organization Name | MICHIGAN STATE UNIVERSITY |
| Practice Address |
1215 E Michigan Ave Sparrow Hospital - Neonatology Unit Lansing MI 48912-1811 |
| Mailing Address |
804 Service Rd Room A201 East Lansing MI 48824-7015 |
| Practice Telephone | 5173642670 |
| Practice Fax Number | 5173643994 |
| Mailing Telephone | 5178842976 |
| Mailing Fax Number | 5174323928 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2018-02-08 |
| Authorized Official Name | MRS. LISA M RUCKER (PROVIDER ENROLLMENT MANAGER) |
| Authorized Official Telephone | 5173558462 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3043440 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184182982 | Michigan State University | Local Education Agency (LEA) | 446 W. Circle Drive, Room 409, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824-1039 | 2019-03-11 |
| 1427443274 | Michigan State University | Behavioral Analyst | 325 W Grand River Ave, East Lansing, MI 48823 | 2015-03-30 |
| 1629307251 | Michigan State University | Preventive Medicine | 346 Olin Health Ctr, East Circle Drive, East Lansing, MI 48824-1037 | 2009-12-10 |
| 1295978054 | Michigan State University | Clinical Medical Laboratory | 1355 Bogue St Rm B228, East Lansing, MI 48824-6207 | 2009-04-09 |
| 1487780565 | Michigan State University | Clinical Medical Laboratory | B228 Life Sciences Bldg, East Lansing, MI 48824 | 2007-02-26 |
| 1518046598 | Michigan State University | Clinic/Center | 804 Clinical Center, A114, East Lansing, MI 48824-1313 | 2006-11-02 |
| 1639253784 | Michigan State University | Registered Nurse | 804 Service Rd Ste A142, East Lansing, MI 48824-7015 | 2006-10-25 |
| 1962515221 | Michigan State University | Pharmacy | 463 E Circle Dr. Rm103, East Lansing, MI 48824 | 2006-08-17 |
| 1992712053 | Michigan State University | Occupational Therapist | 4660 S Hagadorn Rd Ste 400, East Lansing, MI 48823-5353 | 2006-08-02 |
| 1891747614 | Michigan State University | Radiology | 804 Service Rd # D100, East Lansing, MI 48824-7015 | 2006-05-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MICHIGAN STATE UNIVERSITY | 426 Auditorium Rd, East Lansing, MI 48824-2600 |
| Massachusetts Corporations | MICHIGAN STATE UNIVERSITY ALUMNI CLUB OF BOSTON, INC. | 2001 Dogwood Circle, North Andover, MA 01845 |
| Virginia Business Entities | Michigan State University Alumni Club of Metropolitan Washington DC | 10511 Judicial Drive, Fairfax, Virginia 22030-5172 |
| System for Award Management (SAM) Entities | MICHIGAN STATE UNIVERSITY FOUNDATION | 2727 Alliance Dr Ste C, Lansing, MI 48910-3868 |
| Street Address |
1215 E MICHIGAN AVE SPARROW HOSPITAL - NEONATOLOGY UNIT |
| City | LANSING |
| State | MI |
| Zip Code | 48912-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508869108 | Sparrow Specialty Hospital | General Acute Care Hospital | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2005-05-27 |
| 1447850136 | Jennifer Vincent | Clinical Nurse Specialist | 1215 E Michigan Ave, Lansing, MI 48912-1896 | 2020-10-30 |
| 1518564632 | Amanda Elaine Hazen | Nurse Practitioner | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-10-01 |
| 1629682026 | Akhil Sharma | Internal Medicine | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-09-02 |
| 1134733850 | Katie Lukovich | Physician Assistant | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-09-01 |
| 1316550874 | Joshua Wissner | Nurse Anesthetist, Certified Registered | 1215 E Michigan Ave, Lansing, MI 48912-1896 | 2020-08-25 |
| 1174133615 | Si Yuan Khor | Internal Medicine | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-08-07 |
| 1487264677 | Majid Yavari | Internal Medicine | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-08-03 |
| 1124638531 | Anurut Huntrakul | Student in an Organized Health Care Education/Training Program | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-08-01 |
| 1720697626 | Mohammad Fahad Salam | Internal Medicine | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316563646 | Shelley Gabel | Surgery | 1200 E Michigan Ave., Sparrow Professional Building Suite 655, Lansing, MI 48912 | 2020-06-23 |
| 1568087237 | Ahmed Mohamed Haggag | Student in an Organized Health Care Education/Training Program | 1215 East Michigan Avenue 3rd Floor, Lansing, MI 48912 | 2020-06-09 |
| 1467074773 | Craig Hargurkirat Malli | Family Medicine | 1215 E Michigan Avenue Suite 245, Lansing, MI 48912 | 2020-05-08 |
| 1215558945 | Temmy J. Brotherson | Family Medicine | Sparrow Health Systems, 1200 E Michigan Avenues, Suite 245, Lansing, MI 48912 | 2020-05-05 |
| 1386265452 | Kyle Patrick Doran | Emergency Medicine | Sparrow Health System, 1215 E Michigan Avenue, Lansing, MI 48912 | 2020-04-30 |
| 1316418841 | Andrea Mcswain Do PC | Obstetrics & Gynecology | 1909 E. Michigan Ave, Lansing, MI 48912 | 2018-12-10 |
| 1215386115 | Michael Vernon Hollis | Student in an Organized Health Care Education/Training Program | 1500 E Michigan Ave, Suite 655, Lansing, MI 48912 | 2016-06-10 |
| 1518333970 | Eastside Community Action Center | Social Worker | 1001 Dakin Street, Suite B, Lansing, MI 48912 | 2015-08-19 |
| 1649667403 | Cheryl Ann Wade | Counselor | 1712 E Michigan Ave., Lansing, MI 48912 | 2015-04-20 |
| 1083006134 | Carol Pratt | Occupational Therapist | 1200 E. Michigan Ave, Outpatient Rehab - Lower Level, Lansing, MI 48912 | 2015-02-26 |
| Find all providers in zip 48912 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477188555 | Msu Health Care Inc | Pediatrics | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-03-09 |
| 1790334217 | Adila Mohammedfawzi Abulhamail | Pediatrics | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2019-09-06 |
| 1558910216 | Mishref Mohammed Abdelhamid | Pediatrics | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2019-09-05 |
| 1467705798 | Tarek Lotfy Ibrahim Mohamed | Pediatrics | 1215 E Michigan Ave, Sparrow Hospital, Neonatology Unit, 3rd Floor, Lansing, MI 48912-1811 | 2012-10-24 |
| 1174835623 | Erica Gatien | Pediatrics | 1215 E Michigan Ave, Division of Neonatology, Lansing, MI 48912-1811 | 2010-07-12 |
| 1164624912 | Lalitha Gundamraj | Pediatrics | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2007-06-04 |
| 1093926883 | Paula Marie Urban | Pediatrics | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2007-05-24 |
| 1720291339 | Modupe Temidayo Awonuga | Pediatrics | 1215 E Michigan Ave, Sparrow Hospital - Neonatology, Lansing, MI 48912-1811 | 2007-05-08 |
| 1588768642 | Said Abdel-razik Omar | Pediatrics | 1215 E Michigan Ave, Neonatology Unit, Lansing, MI 48912-1811 | 2006-09-11 |
| 1427150861 | Isoken Nicholas Olomu | Pediatrics | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2006-09-05 |
| Find all providers in LANSING | ||||
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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.