MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL (NPI# 1639420557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639420557 |
| Entity Type | Organization |
| Organization Name | MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL |
| Other Organization Name | OMH MEDICAL GROUP - INDIAN RIVER RHC |
| Practice Address |
3860 S Straits Hwy Indian River MI 49749 |
| Mailing Address |
271 Mccoy Rd W Gaylord MI 49735-8253 |
| Practice Telephone | 2312380581 |
| Practice Fax Number | 2312380586 |
| Mailing Telephone | 9897317777 |
| Mailing Fax Number | 9897317776 |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2018-08-22 |
| Authorized Official Name | MR. THOMAS R LEMON (CEO) |
| Authorized Official Telephone | 9897312230 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE OSCAR/CERTIFICATION 2 | 23-8660 | 01 |
| Other Name | Type Code |
|---|---|
| Munson Healthcare OMH Medical Group-Indian River RHC | Doing Business As Name - Organization |
| OMH Medical Group - Indian River RHC | Doing Business As Name - 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 |
| 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 |
| 1487791695 | Munson Healthcare Otsego Memorial Hospital | General Practice | 1996 Walden Dr, Gaylord, MI 49735 | 2007-01-30 |
| Street Address |
3860 S STRAITS HWY |
| City | INDIAN RIVER |
| State | MI |
| Zip Code | 49749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811279789 | Beth Marie Wilson | Nurse Practitioner | 3860 S Straits Hwy, Indian River, MI 49749-5146 | 2011-09-15 |
| 1750911434 | Amanda Radocy | Family Medicine | 3860 S Straits Hwy, Indian River, MI 49749-5146 | 2020-01-22 |
| 1346655149 | Joshua W Saur | Family Medicine | 3860 S Straits Hwy, Indian River, MI 49749-5146 | 2014-07-01 |
| 1053661231 | Munson Healthcare Otsego Memorial Hospital | General Practice | 3860 S Straits Hwy, Indian River, MI 49749 | 2012-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518497353 | Kane Rx Inc | Pharmacy | 3944 South Straits Hwy, Indian River, MI 49749 | 2017-06-14 |
| 1598146516 | Sarah Ellen Stearns | Nurse Practitioner | 3860 S Straits Highway, Indian River, MI 49749 | 2015-06-16 |
| 1750781688 | Katheleen Joan Hart | Counselor | 3948 S. Straits Hwy, South Building, Suite 1, Indian River, MI 49749 | 2014-08-28 |
| 1467863993 | Tom Zoyiopoulos | Pharmacist | 1201 Lears, Indian River, MI 49749 | 2014-05-19 |
| 1750533246 | Xcel Physical Therapy, Plc | Occupational Therapist | 351 S Straits Hwy, Indian River, MI 49749 | 2008-10-16 |
| 1407904436 | Jennifer Ann Andrew I | Specialist/Technologist | 3805 S. Sraits Hwy., Indian River, MI 49749 | 2007-01-08 |
| 1952321390 | Douglas A Furman | Family Medicine | 7037 West M-68 Hwy, Indian River, MI 49749 | 2006-07-20 |
| 1518983006 | Jennifer A Atkins | Pediatrics | 3860 S. Straits Highway, Indian River, MI 49749 | 2006-07-15 |
| 1609800119 | Robin L Batchelor | Physician Assistant | 6135 Cressy St, Indian River, MI 49749 | 2006-07-10 |
| 1659871705 | Sharon Vadovic | Pharmacist | 3944 S Straits Hwy, Indian River, MI 49749 | 2018-02-15 |
| Find all providers in zip 49749 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972589489 | Memorial Medical Center of West Michigan | General Acute Care Hospital | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2005-12-16 |
| 1396732103 | West Branch Regional Medical Center | General Acute Care Hospital | 2463 S M 30, West Branch, MI 48661-9312 | 2005-10-06 |
| 1720589740 | Kathleen Grace Haas | General Acute Care Hospital | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2018-02-25 |
| 1083010953 | Munson Healthcare Grayling | General Acute Care Hospital | 1100 E Michigan Ave, Grayling, MI 49738-1312 | 2014-11-05 |
| 1548662893 | Marquette General Hosptial-dlp | General Acute Care Hospital | 580 W College Ave, Marquette, MI 49855-2736 | 2014-09-18 |
| 1306277421 | Setu Sharma | General Acute Care Hospital | 234 Lake St, Roscommon, MI 48653-9203 | 2013-12-01 |
| 1184947756 | Huron Valley Sinai Hospital | General Acute Care Hospital | 1 William Carls Dr, Ohs, Commerce Township, MI 48382-2201 | 2010-03-10 |
| 1598099699 | Sturgis Hospital, Inc. | General Acute Care Hospital | 916 Myrtle St, Sturgis, MI 49091-2326 | 2009-09-23 |
| 1144479338 | Bell Memorial Hospital | General Acute Care Hospital | 101 S 4th St, Ishpeming, MI 49849-2151 | 2008-09-12 |
| 1881877819 | Alpena Regional Medical Center Behavioral Health Services | General Acute Care Hospital | 1501 W Chisholm St, Alpena, MI 49707-1401 | 2007-12-13 |
| Find all providers with the same taxonomy | ||||
| City | INDIAN RIVER |
| Zip Code | 49749 |
Please comment or provide details below to improve the information on MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL.
| 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.