Sparrow Eaton Hospital
Organization Active NPI School Nurse Practitioner · East Lansing, MI
NPI 1063227486 · NPPES record last updated Feb 12, 2025
Key facts
- NPI
- 1063227486
- Entity type
- Organization (NPI type 2)
- Primary specialty
- School Nurse Practitioner 363LS0200X
- Legal business name
- SPARROW EATON HOSPITAL
- Practice address
- 509 Burcham Dr Ste 59
East Lansing, MI 48823-2750 - Phone
- (517) 253-6320
- NPI assigned
- Feb 12, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARROW HEALTH SYSTEM
Authorized official
- Name
- Misty Gunter Russian
- Title
- Regional Manager, Provider Enrollme
- Phone
- (517) 253-6308
Other NPIs on the same Medicare enrollment 9
Member of 1
Practitioners 157
-
Dennis Sarabia Ahmad, D.O., M.P.H
-
Hussein M. Ali-Ahmad, M.D.
-
Denise Lynn Berry, CRNA
-
Sandra Sloane Blix, CRNA
-
Rebecca Jean Boik, CRNA
-
Payal Boss, MD
-
Roselinde Alaine Boyne, MSN, APRN, FNP-C
-
Amber Brissette, NP
-
Carissa Camp, NP-C
-
Jennifer Churchill, MSN
-
Julia F Coenen, NP
-
Daniel C Coffey, M.D.
-
Matthew David Cohen, D.O.
-
Joel M Cohn, MD
-
Kimberly Marie Comeau, PA-C
-
Nicholas Crofut, CRNA
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2332640 | East Lansing Public Schools Health Center | Certificate of waiver | Oct 21, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040213000368 | MI | Part B Supplier - Clinic/Group Practice | 0042103509 |
Receives reassigned benefits from 152 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lansing, MI; Charlotte, MI; Olivet, MI; Grand Ledge, MI; Eaton Rapids, MI; East Lansing, MI |
National Provider Directory
- Part of
- Sparrow Health System
Locations
123 Lansing St
Ste 3C
Charlotte, MI 48813
Phone (517) 543-9564
123 Lansing St
Ste 200
Charlotte, MI 48813
Phone (517) 543-5110
123 Lansing St
Ste B
Charlotte, MI 48813
Phone (517) 541-5954
123 Lansing St
Lowr Level
Charlotte, MI 48813
Phone (517) 541-5845
4545 Butterfield Hwy
Olivet, MI 49076
Phone (517) 541-5800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker |
1041S0200X | |||
| School Nurse Practitioner |
363LS0200X | Yes |
Addresses
Primary practice location
509 Burcham Dr Ste 59
East Lansing, MI 48823-2750
Mailing address
8175 Reliable Pkwy
Chicago, IL 60686-0081
Other names
- East Lansing Public Schools Health Center
Other providers in East Lansing, MI
- Kayla Somsel
- Sonja G. Norris, DDS, PLLC
- Aron C Sousa
- Donna Joan Sowulewski
- Amanda Spagnuolo
- Spartan Healthcare Staffing Services, Inc.
- Spartan Orthotics and Prosthetics
- Rachel Anne Specht
- Special Needs Incorporated
- Specialty Investments
All providers in East Lansing, MI · School Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.