TRAVERSE HEALTH CLINIC AND COALITION (NPI# 1467632059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467632059 |
| Entity Type | Organization |
| Organization Name | TRAVERSE HEALTH CLINIC AND COALITION |
| Other Organization Name | TRAVERSE HEALTH CLINIC |
| Practice Address |
3147 Logan Valley Rd Traverse City MI 49684-4772 |
| Mailing Address |
3155 Logan Valley Rd Traverse City MI 49684-4772 |
| Practice Telephone | 2319350799 |
| Practice Fax Number | 2319350962 |
| Mailing Telephone | 2319350799 |
| Mailing Fax Number | 2319350501 |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2015-12-11 |
| Authorized Official Name | MRS. ARLENE J. BRENNAN (CEO) |
| Authorized Official Telephone | 2319350351 |
| Authorized Official Credential | MHSA |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1730153149 | 05 | |
| MI | 1760702161 | 05 | |
| MI | 1891994026 | 05 | |
| MI | 1255702486 | 05 | |
| MI | 1437155488 | 05 | |
| MI | 1841296613 | 05 | |
| MI | 1669441457 | 05 | |
| MI | 1265517494 | 05 | |
| MI | 1972680411 | 05 | |
| MI | 1619196680 | 05 |
| Other Name | Type Code |
|---|---|
| Traverse Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790276822 | Traverse Health Clinic and Coalition | Clinic/Center | East Fee Hall 965 Fee Road, Room A222, East Lansing, MI 48824 | 2018-05-24 |
| 1407309685 | Traverse Health Clinic and Coalition | Clinic/Center | 1719 S Garfield Ave, Traverse City, MI 49686-4337 | 2016-07-25 |
| 1417322884 | Traverse Health Clinic and Coalition | Clinic/Center | 105 Hall St, Traverse City, MI 49684-2288 | 2015-12-10 |
| Street Address |
3147 LOGAN VALLEY RD |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-4772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972680411 | Lynn Lapointe Swan | Family Medicine | 3147 Logan Valley Rd, Traverse City, MI 49684-4772 | 2006-11-01 |
| 1174841720 | Jane Marie Stauffer | Nurse Practitioner | 3147 Logan Valley Rd, Traverse City, MI 49684-4772 | 2010-05-06 |
| 1376790923 | Thomas P. Dunfee | Clinic/Center | 3147 Logan Valley Rd, Traverse City, MI 49684-4772 | 2008-08-26 |
| 1386821940 | Leslie Caroline Heimburger | Internal Medicine | 3147 Logan Valley Rd, Traverse City, MI 49684-4772 | 2008-01-25 |
| 1447430236 | Brooke Alice Borgeson-gray | Nurse Practitioner | 3147 Logan Valley Rd, Traverse City, MI 49684-4772 | 2007-11-08 |
| 1619196680 | Ann M Avery | Nurse Practitioner | 3147 Logan Valley Rd, Traverse City, MI 49684-4772 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| 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 |
|---|---|---|---|---|
| 1407309685 | Traverse Health Clinic and Coalition | Clinic/Center | 1719 S Garfield Ave, Traverse City, MI 49686-4337 | 2016-07-25 |
| 1417322884 | Traverse Health Clinic and Coalition | Clinic/Center | 105 Hall St, Traverse City, MI 49684-2288 | 2015-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658244 | Hackley Community Care Center Inc | Clinic/Center | 3113 Pontaluna Rd Ste A, Fruitport, MI 49415-9600 | 2020-10-30 |
| 1760080972 | Hackley Community Care Center Inc | Clinic/Center | 1420 Madison St Ste A, Muskegon, MI 49442-5251 | 2020-10-12 |
| 1831706993 | Family Medical Center of Michigan, Inc | Clinic/Center | 503 Washington St Rm 150, Monroe, MI 48161-1309 | 2020-09-23 |
| 1326654666 | Family Medical Center of Michigan,inc | Clinic/Center | 550 E Main St Ste 1001, Hudson, MI 49247-9535 | 2020-09-22 |
| 1922613975 | Hackley Community Care Center Inc | Clinic/Center | 6245 Syers Rd Ste A, Holton, MI 49425-7557 | 2020-09-15 |
| 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 | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
Please comment or provide details below to improve the information on TRAVERSE HEALTH CLINIC AND COALITION.
| 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.