Sparrow Carson Hospital
Organization Active NPI Rural Health Clinic/Center · Carson City, MI
NPI 1013987833 · NPPES record last updated Apr 5, 2024
Key facts
- NPI
- 1013987833
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- SPARROW CARSON HOSPITAL
- Practice address
- 102 S. Third St
Suite 100
Carson City, MI 48811 - Phone
- (989) 584-1308
- Fax
- (989) 584-0307
- NPI assigned
- Jan 24, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARROW HEALTH SYSTEM
Authorized official
- Name
- Misty Gunter Russian
- Title
- Supervisor, Provider Enrollment
- Phone
- (517) 253-6308
Owners & managing parties with NPI records 4
-
Gregory A Holzhei, D.O.
-
Lakeeya K Tucker, DO
-
Matthew D Wilcox, DO
-
Harper T Wildern, O.D.
Other NPIs on the same Medicare enrollment 19
Other NPIs with the same Medicare PAC ID 7
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 16
Practitioners 125
-
Amanda Elizabeth Bennett, FNP-C
-
Hillary Agnes Shemes, D.O.
-
Cheryl Lynn Young, FNP
-
Chelsea N Barnes, FNP-C
-
Mary Lynne Barringer, WHNP-BC
-
Michelle Leigh Becher, D.O., FACOOG
-
Shelly L Betancourt, MSN,MHA,WHNP-BC
-
Annie Garn, RN, NP
-
Ronald Allen Hyde, D.O.
-
Amy B Jentz, M.D.
-
Aimee Lee Johnson, FNP-C
-
Maria Koularmanis, PA-C
-
Jacqueline Marie Kreft, PA-C
-
Ashley Lynn Maiville, FNP-C
-
Jamie M Manning, P.A.
-
Roy Miller, D.O
-
Wanda Kay Myers, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Rural health clinic certification: CCN 233994
- Legal name
- SPARROW CARSON HOSPITAL
- Doing business as
- UNIVERSITY OF MICHIGAN HEALTH-SPARROW CARSON PRIMARY CARE
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 1, 1997
- Last certification
- Dec 21, 2021
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 102 S 3Rd St
Ste 100
Carson City, MI 48811-5115 - Related CCNs
- 230208
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Matthew D Wilcox |
Corporate Officer |
Jul 1, 2025 | |
| Eric J Strucko |
Corporate Officer |
Jul 1, 2025 | |
| Laura M Gibson |
Corporate Officer |
Jul 1, 2025 | |
| Candace S Metcalf |
Corporate Officer |
Jul 1, 2025 | |
| Harper T Wildern |
Corporate Officer |
Jul 1, 2025 | |
| Margaret a Dimond |
Corporate Officer |
Jan 1, 2024 | |
| W-2 Managing Employee |
Jan 1, 2024 | ||
| Misty Gunter Russian |
W-2 Managing Employee |
Jan 1, 2024 | |
| Daniel Balice |
Corporate Officer |
Jul 1, 2025 | |
| Carol Priebe Wiles |
Corporate Officer |
Jul 1, 2025 | |
| Sparrow Health System |
5% Or Greater Direct Ownership Interest | Feb 1, 2015 | 100% |
| John Milewski |
Corporate Officer |
Jul 1, 2025 | |
| Gregory a Holzhei |
Corporate Officer |
Jul 1, 2025 | |
| John Hendrickson |
Corporate Officer |
Jul 1, 2025 | |
| Bruce a Courtade |
Corporate Officer |
Jul 1, 2025 | |
| Anthony Mazzali |
Corporate Officer |
Jul 1, 2025 | |
| Timothy L Williams |
Corporate Officer |
Jul 1, 2025 | |
| Lakeeya K Tucker |
Corporate Officer |
Jul 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040126000046 | MI | Part B Supplier - Clinic/Group Practice | 7113836701 |
Receives reassigned benefits from 241 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Greenville, MI; Stanton, MI; Mount Pleasant, MI; Ithaca, MI; Fowler, MI; Carson City, MI |
| O20071025000646 | MI | Part a Provider - Rural Health Clinic | 7113836701 | Practice locations: Carson City, MI |
National Provider Directory
- Part of
- Sparrow Health System
Locations
1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
102 S. Third St
Suite 100
Carson City, MI 48811
Mailing address
8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (989) 584-3131
Other names
- University of Michigan Health-Sparrow
- University of Michigan Health-Sparrow Carson Primary Care
Other providers in Carson City, MI
- Robert H Seals
- Seth T. Ferguson D O P C
- Monte Shearer II
- Jessica Ann Skinner
- Deanna L Small
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
All providers in Carson City, MI · Rural Health Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.