NPIMap

Organization Active NPI

Paul Oliver Memorial Hospital

  • Rural Health Clinic/Center
  • Empire, MI
National Provider Identifier
1013578897
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PAUL OLIVER MEMORIAL HOSPITAL
Practice address
9975 W Ottawa Ave
Empire, MI 49630-9618
Phone
(231) 835-2088
Fax
(231) 835-2534
NPI assigned
Jun 24, 2019
Last updated
Apr 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Michael Frye, MD
Title
Pres. Ambulatory & Bus. Development
Phone
(704) 458-8010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

9975 W Ottawa Ave
Empire, MI 49630-9618

Mailing address

9975 W Ottawa Ave
Empire, MI 49630-9618
Phone (231) 835-2088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040225000359 MI Part B Supplier - Clinic/Group Practice 8628964848 Receives reassigned benefits from 33 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kalkaska, MI; Traverse City, MI; Manistee, MI; Grayling, MI; Gaylord, MI; Frankfort, MI; Empire, MI; Charlevoix, MI…
O20190729003703 MI Part A Provider - Rural Health Clinic 8628964848 Practice locations: Empire, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013578897. Details of each certification follow.

Rural health clinic certification: CCN 238719

Legal name
PAUL OLIVER MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 16, 2020
Last certification
Apr 16, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
9975 W Ottawa Ave
Empire, MI 49630-9618
Related CCNs
231300

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Paul Oliver Mem Hosp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: kvolas@direct.mhc.net

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Page Individual Corporate OfficerTrustee Jan 1, 2024
Ruth Hoppe Individual Operational/Managerial ControlSecretary Jan 1, 2022
Paul Konopacki Individual Corporate OfficerCfo Jan 1, 2024
W-2 Managing EmployeeCfo Jan 1, 2024
Operational/Managerial ControlCfo Jan 1, 2024
Vincent Schultz Individual Corporate OfficerTrustee Jan 1, 2024
Thomas Veryser Individual Operational/Managerial ControlTrustee Jan 1, 2022
Kenneth D Bloem Individual Operational/Managerial ControlVice Chair Jan 1, 2022
Timothy Nelson Individual Operational/Managerial ControlTreasurer Jan 1, 2022
David Menegebier Individual Corporate OfficerTrustee Jan 1, 2024
Edward Lanphier Individual Corporate Director Jan 1, 2026
Kathy Dixon Individual Operational/Managerial ControlTrustee Jan 1, 2022
Mary Sanders Individual Corporate OfficerTrustee Jan 1, 2022
Elaine Wood Individual Operational/Managerial ControlChair Jan 1, 2022
Claudia Rowland Individual Corporate Director Jan 1, 2026
Munson Healthcare Organization, Traverse City, MI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 30, 1986 100%
Peter E Marinoff Individual Corporate OfficerPresident/Ceo South Region Jan 1, 2024
W-2 Managing EmployeePresident/Ceo South Region Jan 1, 2024
Operational/Managerial ControlPresident/Ceo South Region Jan 1, 2024
Edwin a Ness Individual Corporate DirectorTrustee Jan 1, 2018
Owen Roberts Individual Corporate OfficerTrustee Jan 1, 2022
Bruce Zenner Individual Corporate OfficerTrustee Jan 1, 2022
Sakura Takano Individual Corporate OfficerTrustee Jan 1, 2022
Kristine Thomas Individual Operational/Managerial ControlTrustee Jan 1, 2022
Brian Postma Individual Corporate OfficerTrustee Jan 1, 2022
Dino Recchia Individual Corporate OfficerTrustee Jan 1, 2024
Jennifer King Individual Corporate OfficerTrustee Jan 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 24

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 24

Practitioners & affiliated clinicians

Practitioners 6

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": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1013578897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9975 W OTTAWA AVE",
            "city": "EMPIRE",
            "state": "MI",
            "postal_code": "496309618",
            "telephone_number": "231-835-2088",
            "fax_number": "231-835-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9975 W OTTAWA AVE",
            "city": "EMPIRE",
            "state": "MI",
            "postal_code": "496309618",
            "telephone_number": "231-835-2088",
            "fax_number": "231-835-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL OLIVER MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-24",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "FRYE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRES. AMBULATORY & BUS. DEVELOPMENT",
        "authorized_official_telephone_number": "704-458-8010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Empire, MI

Sources for this page

Verify at the official NPI Registry.