Munson Medical Center

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

Legal business name

MUNSON MEDICAL CENTER

Practice address

1105 Sixth St
Traverse City, MI 49684-2345

Phone

(231) 935-9227

Fax

(231) 935-8215

NPI assigned

Jan 22, 2019

Last updated

Sep 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ellen O Smith

Title

President Ambulatory Clinics

Phone

(231) 935-5199

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1073087292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895325",
            "telephone_number": "231-935-6080",
            "fax_number": "231-935-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-9227",
            "fax_number": "231-935-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT AMBULATORY CLINICS",
        "authorized_official_telephone_number": "231-935-5199"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Munson Manor Hospitality House
• Munson Medical Center (Munson Walk In Clinic)
• Munson Medical Center
• Munson Medical Center (Munson Pulmonary & Critical Care of Northwest Michigan)
• Munson Medical Center
• Munson Medical Center
• Munson Medical Center (Endocrinology and Metabolism)
• Munson Medical Center
• Munson Medical Center (Munson Home Infusion)
• Munson Medical Center (Munson Healthcare Specialty Pharmacy)

• Diabetes Educator Registered Nurse in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Diabetes Educator Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.