NPIMap

Organization Active NPI

Community Memorial Hospital

  • Family Medicine Physician
  • Cheboygan, MI
National Provider Identifier
1003837741
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
160020 Issued in MI
Legal business name
COMMUNITY MEMORIAL HOSPITAL
Practice address
748 S Main St
Cheboygan, MI 49721-2220
Phone
(231) 627-5601
Fax
(231) 627-1471
NPI assigned
Jul 21, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Ted P Anderson
Title
Vice President/Finance
Phone
(231) 627-1203

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 160020 MI Primary
Internal Medicine Physician 207R00000X 160020 MI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 160020 MI

Addresses

Primary practice location

748 S Main St
Cheboygan, MI 49721-2220

Mailing address

PO Box 419
Cheboygan, MI 49721-0419
Phone (231) 627-1438

Other names 1

  • Cheboygan Memorial Hospital Hospitalist Group Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1003837741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497210419",
            "telephone_number": "231-627-1438",
            "fax_number": "231-627-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 S MAIN ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212220",
            "telephone_number": "231-627-5601",
            "fax_number": "231-627-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE PRESIDENT/FINANCE",
        "authorized_official_telephone_number": "231-627-1203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "160020",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "160020",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "160020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cheboygan Memorial Hospital Hospitalist Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cheboygan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.