NPIMap

Organization Active NPI

Munson Healthcare Charlevoix Hospital

  • Certified Registered Nurse Anesthetist
  • Charlevoix, MI
National Provider Identifier
1063598845
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Practice address
14734 Park Ave
Charlevoix, MI 49720-1931
Phone
(231) 547-4024
Fax
(231) 547-8088
NPI assigned
Oct 27, 2006
Last updated
Mar 17, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MUNSON HEALTHCARE CHARLEVOIX HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Authorized official

Name
Christine Wilhelm
Title
Chief Operations Officer
Phone
(231) 547-4024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

14734 Park Ave
Charlevoix, MI 49720-1931

Mailing address

14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone (231) 547-4024

Other identifiers 4

IdentifierTypeStateIssuer
20139OtherMICRNA PRIORITY HLTH PRO
0A51005OtherMICRNA BCN PROFESSIONAL
134141100OtherMICRNA COMP CARRIER US POST
1001019OtherMICRNA MCLAREN HEALTH PLAN

Other names 1

  • Charlevoix Area Hospital CRNA Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211001170 MI Part B Supplier - Clinic/Group Practice 4284528035 Receives reassigned benefits from 98 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlevoix, MI; East Jordan, MI

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Charlevoix Area Hosptia13 organizations share this tax ID, including this one
Part of
Charlevoix Area Hosptia

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1063598845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-4024",
            "fax_number": "231-547-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14734 PARK AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-4024",
            "fax_number": "231-547-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE CHARLEVOIX HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUNSON HEALTHCARE CHARLEVOIX HOSPITAL",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "WILHELM",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "231-547-4024"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA PRIORITY HLTH PRO",
            "identifier": "20139",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA BCN PROFESSIONAL",
            "identifier": "0A51005",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA COMP CARRIER US POST",
            "identifier": "134141100",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA MCLAREN HEALTH PLAN",
            "identifier": "1001019",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlevoix Area Hospital CRNA Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlevoix, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.