GRAND TRAVERSE WOMENS CLINIC (NPI# 1942552559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942552559 |
| Entity Type | Organization |
| Organization Name | GRAND TRAVERSE WOMENS CLINIC |
| Practice Address |
1200 Sixth St Ste 400 Traverse City MI 49684-2369 |
| Practice Telephone | 2313920655 |
| Practice Fax Number | 2313920691 |
| Mailing Telephone | 2313920655 |
| Mailing Fax Number | 2313920691 |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2016-02-24 |
| Authorized Official Name | MS. BARBARA ROGERS (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 2313920655 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
4704273686 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE | 4704273686 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558483362 | Grand Traverse Womens Clinic | Midwife | 1200 Sixth St, Ste 400, Traverse City, MI 49684-2369 | 2007-04-04 |
| Street Address |
1200 SIXTH ST STE 400 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-2369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174522429 | Steven T Mast | Internal Medicine | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2005-07-19 |
| 1457913337 | Hannah M Popa | Nurse Practitioner | 1200 Sixth St, Ste 400, Traverse City, MI 49684-2369 | 2019-07-01 |
| 1396106266 | Edward Kraska | Nurse Practitioner | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2016-03-18 |
| 1386000370 | Michelle Strange | Physician Assistant | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2016-01-07 |
| 1295153062 | Barbara Rogers | Obstetrics & Gynecology | 1200 Sixth St, Ste 400, Traverse City, MI 49684-2369 | 2014-03-31 |
| 1033458534 | Meghan J Visnick | Nurse Practitioner | 1200 Sixth St, Ste 400, Traverse City, MI 49684-2369 | 2013-02-05 |
| 1427308626 | Sarah K Torres | Nurse Practitioner | 1200 Sixth St, Ste 400, Traverse City, MI 49684-2369 | 2012-09-14 |
| 1992081640 | Regents of The University of Michigan | Pediatrics | 1200 Sixth St, Suite 100, Traverse City, MI 49684-2369 | 2011-10-26 |
| 1821398322 | Munson Medical Group | Internal Medicine | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2010-10-30 |
| 1518286046 | John L Coatney | Internal Medicine | 1200 Sixth St, Traverse City, MI 49684 | 2010-05-24 |
| Find all providers in the same location | ||||
| 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 | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013222587 | Munson Medical Center | Nurse Practitioner | 1105 Sixth St, Traverse City, MI 49684-2345 | 2010-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255607032 | Maureen M Westfall | Nurse Practitioner | 4200 Whitehall Dr Ste 330, Ann Arbor, MI 48105-9694 | 2012-03-27 |
| 1306121660 | Julie Sokolow | Nurse Practitioner | 317 S Drake Rd Ste B, Kalamazoo, MI 49009-1171 | 2011-10-19 |
| 1073835302 | Leah Foucart | Nurse Practitioner | 6920 Tamarack Ln, Holly, MI 48442-9157 | 2010-03-01 |
| 1265547749 | Karen J Pociluyko | Nurse Practitioner | 205 N Hintz Rd, Owosso, MI 48867-9019 | 2006-08-21 |
| 1790765139 | Kyoung Kelly Lee | Nurse Practitioner | 3300 West Centre Ave, Bronson Ob/gyn Associates, Portage, MI 49024 | 2006-01-20 |
| 1063924926 | Jennifer Ann Soper | Nurse Practitioner | 3300 W Centre Ave, Portage, MI 49024-4666 | 2017-11-01 |
| 1790206019 | Christy Lynn Klieman | Nurse Practitioner | 1701 South Boulevard, East, Suite 200, Rochester Hills, MI 48307 | 2017-06-28 |
| 1942613252 | Lorrie Lorraine Youngs | Nurse Practitioner | 2012 E Preston St, Mt Pleasant, MI 48858-8990 | 2014-06-04 |
| 1861814220 | Jeanna Mastracci | Nurse Practitioner | 44344 Dequindre Rd, Sterling Heights, MI 48314-1038 | 2014-01-19 |
| 1639517758 | Sarah Sharp | Nurse Practitioner | 8333 Felch St Ste 202, Zeeland, MI 49464-2609 | 2013-06-11 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.