NPIMap

Organization Active NPI

Mymichigan Medical Center Clare

Doing business as MyMichigan Family Medicine

  • Rural Health Clinic/Center
  • Harrison, MI
National Provider Identifier
1073842431
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MYMICHIGAN MEDICAL CENTER CLARE
Doing business as
MyMichigan Family Medicine
Practice address
815 N Clare Ave
Harrison, MI 48625-9194
Phone
(989) 802-5102
NPI assigned
Dec 15, 2009
Last updated
Jan 15, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MYMICHIGAN MEDICAL CENTER CLAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Authorized official

Name
Sarah James
Title
Manager, Provider Enrollment
Phone
(989) 701-4734

Specialties & licenses 1

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

Addresses

Primary practice location

815 N Clare Ave
Harrison, MI 48625-9194

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (844) 832-1956

Other identifiers 1

IdentifierTypeStateIssuer
23-8640OtherMIMEDICARE PTAN

Other names 1

  • MyMichigan Family Medicine Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040720000582 MI Part B Supplier - Clinic/Group Practice 7012829773 Receives reassigned benefits from 98 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clare, MI
O20110513000458 MI Part A Provider - Rural Health Clinic 7012829773 1 other NPI on this enrollment
Practice locations: Harrison, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073842431. Details of each certification follow.

Rural health clinic certification: CCN 238640

Legal name
MYMICHIGAN MEDICAL CENTER CLARE
Doing business as
MYMICHIGAN INTERNAL & FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 2010
Last certification
Mar 11, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
815 N Clare Ave
Ste a
Harrison, MI 48625-8177
Related CCNs
230180

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

Other NPIs with the same Medicare PAC ID 8

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
Part of
Clare Community Hosp OB

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Paula Lancaster Individual Corporate DirectorBoard Member Mar 1, 2026
Kati Mora Individual Corporate DirectorBoard Member Mar 1, 2026
Harmony Nowlin Individual Corporate DirectorBoard Member Mar 1, 2026
Sarah James Individual Corporate OfficerBoard Member Jul 1, 2025
Nathan Rogers Individual Corporate DirectorBoard Member Mar 1, 2026
Lydia Watson Individual Corporate Officer Sep 11, 2023
Jennifer Siefker Individual Corporate DirectorBoard Member Mar 1, 2026
Samantha Hunter Individual W-2 Managing Employee Jan 1, 2022
Erik L Nimbley Individual Corporate DirectorBoard Member Mar 1, 2026
Alan White Individual Corporate DirectorBoard Member Mar 1, 2026
Bryan R Cross Individual Corporate DirectorBoard Member Mar 1, 2026
George M Elliott Individual Corporate DirectorBoard Member Mar 1, 2026
Tina Church Individual Corporate Director Apr 1, 2021
W-2 Managing Employee Apr 1, 2021
Mymichigan Health Organization, Midland, MI Corporation 5% Or Greater Direct Ownership Interest Apr 1, 2021 100%
Tricia Gorde Individual Corporate DirectorDirector of Operations Jan 20, 2025
Adam Geers Individual Corporate DirectorBoard Member Mar 1, 2026
Charles Sherwin Individual Corporate DirectorBoard Member Mar 1, 2026

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 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1073842431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "844-832-1956",
            "fax_number": "989-633-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N CLARE AVE",
            "city": "HARRISON",
            "state": "MI",
            "postal_code": "486259194",
            "telephone_number": "989-802-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMICHIGAN MEDICAL CENTER CLARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYMICHIGAN MEDICAL CENTER CLARE",
        "enumeration_date": "2009-12-15",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "MANAGER, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "989-701-4734"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "23-8640",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyMichigan Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, MI

Sources for this page

Verify at the official NPI Registry.