Individual provider Active NPI

Tara Stone, MD, MPH

  • Emergency Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1003546607
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4351049287 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-5000
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4351049287 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Other names 1

  • Tara Knisely Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703000261 MI Practitioner - Emergency Medicine 1951783943 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351049287MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Memorial Hospital CurrentSince Jul 1, 2024 Accepting new patients
Caberfae Emergency Group, P.C. Emergency Medicine CurrentSince Dec 21, 2024 Accepting new patients
Hawk Emergency Group, P.C. Emergency Medicine CurrentSince Dec 21, 2024 Accepting new patients
McKenzie Memorial Hospital Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

120 N Delaware St
Sandusky, MI 48471
Phone (810) 648-3770

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1003546607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "TARA",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4351049287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "KNISELY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.