MIDMICHIGAN MEDICAL CENTER CLARE (NPI# 1619419504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619419504 |
| Entity Type | Organization |
| Organization Name | MIDMICHIGAN MEDICAL CENTER CLARE |
| Practice Address |
703 N Mcewan St Clare MI 48617-1440 |
| Mailing Address |
702 N Mcewan St Clare MI 48617-1409 |
| Practice Telephone | 9898025000 |
| Mailing Telephone | 9898025000 |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-10 |
| Authorized Official Name | MR. RAY STOVER (PRESIDENT) |
| Authorized Official Telephone | 9898025101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 180010 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407297104 | Midmichigan Medical Center Clare | Clinic/Center | 703 N Mcewan St, Clare, MI 48617-1440 | 2013-07-10 |
| 1619229663 | Midmichigan Medical Center Clare | Clinic/Center | 40 W Saginaw Rd, Sanford, MI 48657-9206 | 2012-10-15 |
| 1164736039 | Midmichigan Medical Center Clare | Clinic/Center | 2618 W Sugnet Rd, Midland, MI 48640-2647 | 2010-08-03 |
| 1376872341 | Midmichigan Medical Center Clare | Clinic/Center | 602 Beech St, Clare, MI 48617-1466 | 2009-12-21 |
| 1982933347 | Midmichigan Medical Center Clare | Clinic/Center | 2812 W Cadillac Dr, Farwell, MI 48622-9757 | 2009-12-15 |
| 1073842431 | Midmichigan Medical Center Clare | Clinic/Center | 815 N Clare Ave, Harrison, MI 48625-9194 | 2009-12-15 |
| 1134394026 | Midmichigan Medical Center Clare | Physician Assistant | 703 N Mcewan St, Clare, MI 48617-1440 | 2008-04-23 |
| 1568414589 | Midmichigan Medical Center Clare | General Acute Care Hospital | 703 N Mcewan St, Clare, MI 48617-1440 | 2006-05-17 |
| Street Address |
703 N MCEWAN ST |
| City | CLARE |
| State | MI |
| Zip Code | 48617-1440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639154768 | Roger Beaudoing | Emergency Medicine | 703 N Mcewan St, Clare, MI 48617-1440 | 2005-12-13 |
| 1710457148 | Jessica Katherine Gust | Physician Assistant | 703 N Mcewan St, Clare, MI 48617-1440 | 2018-11-28 |
| 1801398870 | Marysusan V. Snively | Physical Therapist | 703 N Mcewan St, Clare, MI 48617-1440 | 2018-03-06 |
| 1912419110 | Katherine S Watson | Nurse Practitioner | 703 N Mcewan St, Clare, MI 48617-1440 | 2017-10-27 |
| 1013360916 | Midmichigan Medical Center - Clare | Nurse Practitioner | 703 N Mcewan St, Clare, MI 48617-1440 | 2016-07-15 |
| 1083084487 | Calli Cadieu Chouinard | Physician Assistant | 703 N Mcewan St, Clare, MI 48617-1440 | 2015-09-29 |
| 1962888180 | Midmichigan Medical Center - Clare | Emergency Medicine | 703 N Mcewan St, Clare, MI 48617-1440 | 2015-08-11 |
| 1407297104 | Midmichigan Medical Center Clare | Clinic/Center | 703 N Mcewan St, Clare, MI 48617-1440 | 2013-07-10 |
| 1073881629 | Kelly Marie Mathison | Registered Nurse | 703 N Mcewan St, Clare, MI 48617-1440 | 2011-12-11 |
| 1790067619 | Melissa R Bowman | Physician Assistant | 703 N Mcewan St, Clare, MI 48617-1440 | 2011-09-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538598826 | Katrina Carrigan | Occupational Therapy Assistant | 600 Sw 4th Street, Clare, MI 48617 | 2013-11-06 |
| 1891075073 | Amy Ellen Weber | Nurse Practitioner | 703 Mcewan St., Midmichigan Medical Center, Clare, MI 48617 | 2011-08-19 |
| 1053615708 | Dale J Moser | Eyewear Supplier (Equipment, not the service) | 1520 N Mcewan St, Clare, MI 48617 | 2011-01-10 |
| 1063571719 | Alpha Chiropractic Clinic Inc | Chiropractor | 1424 N Mcewan Street, Clare, MI 48617 | 2006-12-08 |
| 1245324888 | Paula L Myers | Occupational Therapist | 4139 E Coleman Rd, Clare, MI 48617 | 2006-10-03 |
| 1629023403 | Russell Glyn Rader | Nurse Anesthetist, Certified Registered | 703 Mcewan, Clare, MI 48617 | 2006-05-23 |
| 1659330702 | Trisha Anne Mcmillan | Physical Therapist | 107 Schoolcrest, Clare, MI 48617 | 2006-03-18 |
| 1043641541 | Denise Ann Carrier | Licensed Practical Nurse | 810 Cedar St, Clare, MI 48617 | 2013-12-09 |
| 1487876041 | Midmichigan Visiting Nurse Association | Durable Medical Equipment & Medical Supplies | 1432 N Mcewan St, Clare, MI 48617 | 2007-05-03 |
| 1417916560 | Patrick L Howe | Physical Therapist | 107 Schoolcrest, Clare, MI 48617 | 2006-03-18 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912419110 | Katherine S Watson | Nurse Practitioner | 703 N Mcewan St, Clare, MI 48617-1440 | 2017-10-27 |
| 1013360916 | Midmichigan Medical Center - Clare | Nurse Practitioner | 703 N Mcewan St, Clare, MI 48617-1440 | 2016-07-15 |
| 1407228026 | Lindsey Elias | Nurse Practitioner | 700 W 5th St, Clare, MI 48617-9414 | 2015-10-22 |
| 1942575907 | Julie Ann Reneaud | Nurse Practitioner | 602 Beech St, Clare, MI 48617-1466 | 2012-03-09 |
| 1962792929 | Michigan Em-i Medical Services, PC | Nurse Practitioner | 703 N Mcewan St, Er Dept, Clare, MI 48617-1440 | 2011-04-12 |
| 1538480942 | Midmichigan Medical Center - Clare | Nurse Practitioner | 602 Beech St, Clare, MI 48617-1466 | 2010-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154599 | Kelly Phuong Doan | Nurse Practitioner | 27327 23 Mile Rd, Chesterfield, MI 48051-2045 | 2020-11-04 |
| 1275133217 | Maureen Mae Lewis | Nurse Practitioner | 2782 N Coleman Rd, Coleman, MI 48618-9721 | 2020-10-29 |
| 1073113460 | Taylor L Pichette | Nurse Practitioner | 758 Lucille Dr, Wolverine Lake, MI 48390-2327 | 2020-10-27 |
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1689271314 | Nicole Conklin | Nurse Practitioner | 524 Doyle Rd, Laingsburg, MI 48848-9611 | 2020-10-06 |
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1497361638 | Amira Aljamal | Nurse Practitioner | 4601 Shenandoah Ave, Allen Park, MI 48101-3131 | 2020-09-22 |
| 1659987014 | Sean Thomas Kane | Nurse Practitioner | 13734 Parallel Ave, Alpena, MI 49707-7987 | 2020-09-21 |
| 1235743592 | Mojica, LLC | Nurse Practitioner | 4163 W Pointe Dr, Waterford, MI 48329-4648 | 2020-09-03 |
| 1942812094 | Meagan James | Nurse Practitioner | 407 E Huron River Dr, Belleville, MI 48111-2763 | 2020-08-20 |
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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.