NORTHWESTERN MICHIGAN COLLEGE (NPI# 1700033859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700033859 |
| Entity Type | Organization |
| Organization Name | NORTHWESTERN MICHIGAN COLLEGE |
| Other Organization Name | NORTHWESTERN MICHIGAN COLLEGE STUDENT HEALTH SERVICES |
| Practice Address |
1701 E Front St L.b. 106 Traverse City MI 49686-3016 |
| Practice Telephone | 2319951255 |
| Practice Fax Number | 2319951923 |
| Mailing Telephone | 2319951255 |
| Mailing Fax Number | 2319951923 |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |
| Authorized Official Name | MS. RENEE ROSE JACOBSON (DIRECTOR OF HEALTH SERVICES) |
| Authorized Official Telephone | 2319951256 |
| Authorized Official Credential | F.N.P. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
4704147470 | MI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Northwestern Michigan College Student Health Services | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHWESTERN MICHIGAN COLLEGE | 1701 E Front St, Traverse City, MI 49686-3016 |
| Street Address |
1701 E FRONT ST L.B. 106 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686-3016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619196490 | Renee Rose Jacobson | Nurse Practitioner | 1701 E Front St, Lb 106, Traverse City, MI 49686-3016 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064651 | Donna Parnell | Clinic/Center | 214 N Christine Cir, Mount Clemens, MI 48043-1509 | 2020-05-11 |
| 1669759437 | Baldwin Family Health Care | Clinic/Center | 96 E 120th St Rm N8, Grant, MI 49327-8502 | 2011-11-08 |
| 1184872400 | Genesys Regional Medical Center | Clinic/Center | 2989 Van Zandt Rd, Waterford, MI 48329-3360 | 2008-08-28 |
| 1134398027 | Southeastern Michigan Health Association | Clinic/Center | 11447 Joseph Campau, Hamtramck, MI 48212 | 2008-02-25 |
| 1316160971 | Leslie Medical Center P C | Clinic/Center | 207 E Bellevue St, Leslie, MI 49251-9373 | 2007-04-11 |
| 1538287313 | Great Lakes Bay Health Centers | Clinic/Center | 3100 Webber St, Saginaw, MI 48601-4066 | 2007-03-27 |
| 1033253794 | Children's Ambulatory Services, LLC | Clinic/Center | 21431 Grand River Ave, Detroit, MI 48219-3801 | 2007-02-16 |
| 1467950758 | Regents of The Universtiy of Michigan | Clinic/Center | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2018-02-01 |
| 1609147339 | Calvin College | Clinic/Center | 3195 Knight Way Se, Grand Rapids, MI 49546-4409 | 2012-01-26 |
| 1790067338 | Baldwin Family Health Care | Clinic/Center | 555 E Wilcox Ave, White Cloud, MI 49349 | 2011-09-09 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
Please comment or provide details below to improve the information on NORTHWESTERN MICHIGAN COLLEGE.
| 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.