NPIMap

Organization Active NPI

Munson Healthcare Grayling

  • Rural Acute Care Hospital
  • Grayling, MI
National Provider Identifier
1083010953
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
MUNSON HEALTHCARE GRAYLING
Practice address
1100 E Michigan Ave
Grayling, MI 49738-1312
Phone
(989) 348-5461
NPI assigned
Nov 5, 2014
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MUNSON HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Kirsten B Korth-White
Title
President/Ceo East Reigon
Phone
(989) 348-0720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X Primary

Addresses

Primary practice location

1100 E Michigan Ave
Grayling, MI 49738-1312

Mailing address

1105 Sixth St
Traverse City, MI 49684-2349
Phone (231) 935-5000

Other identifiers 2

IdentifierTypeStateIssuer
230058MedicaidMI
00030OtherMIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150202000131 MI Part A Provider - Hospital 2062736655 Practice locations: Grayling, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083010953. Details of each certification follow.

Hospital certification: CCN 230058

Legal name
MUNSON HEALTHCARE GRAYLING
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1976
Last certification
May 31, 1991
Beds
90
Ownership / control type
Church
Most recent change of ownership
Feb 1, 2015 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Jun 17, 2014 in MI
Enrollment address
1100E Michigan Ave
Grayling, MI 49738-1312
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Munson Healthcare Grayling HospitalCCN 230058 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Munson Healthcare Grayling Hospital Pharmacy11 organizations share this tax ID, including this one
Part of
Munson Manor Hospitality House

Other organizations with this tax ID 10

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

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61308
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d63001e8-2b2d-46b2-9b8b-4bc37428b829/
  • Direct secure messaging: medrecgry@direct.mhc.net
  • Direct secure messaging: mhc.crawfordschoolproviderservices@direct.mhc.net

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Andrew Page Individual Corporate OfficerTrustee Jan 1, 2024
Ruth Hoppe Individual Corporate Officer Jan 1, 2022
Paul Konopacki Individual Corporate OfficerCfo Jan 1, 2024
Vincent Schultz Individual Corporate OfficerTrustee Jan 1, 2024
Thomas Veryser Individual Corporate OfficerTrustee Jan 1, 2022
Kenneth D Bloem Individual Corporate Officer Jan 1, 2022
Timothy Nelson Individual Corporate Officer Jan 1, 2022
David Menegebier Individual Corporate OfficerTrustee Jan 1, 2024
Edward Lanphier Individual Corporate Officer Jan 1, 2026
Kathy Dixon Individual Corporate Officer Jan 1, 2022
Kirsten Bethany Korth-White Individual Corporate DirectorPresident/Ceo Nov 30, 2023 100%
Mary Sanders Individual Corporate Officer Jan 1, 2022
Elaine Wood Individual Corporate OfficerTrustee Jan 1, 2022
Claudia Rowland Individual Corporate Officer Jan 1, 2026
Munson Healthcare Organization, Traverse City, MI Corporation Operational/Managerial Control Feb 1, 2015
Edwin a Ness Individual Corporate DirectorTrustee Feb 1, 2015
W-2 Managing Employee Jan 1, 2022
Owen Roberts Individual Corporate Officer Jan 1, 2022
Bruce Zenner Individual Corporate OfficerTrustee Jan 1, 2022
Sakura Takano Individual Corporate OfficerTrustee Jan 1, 2022
Kristine Thomas Individual Corporate OfficerTrustee Jan 1, 2022
Brian Postma Individual Corporate Officer Jan 1, 2022
Dino Recchia Individual Corporate OfficerTrustee Jan 1, 2024
Jennifer King Individual Corporate OfficerTrustee Jan 1, 2024

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 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 22

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 22

Affiliated clinicians 368

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 368

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1083010953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842349",
            "telephone_number": "231-935-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497381312",
            "telephone_number": "989-348-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE GRAYLING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUNSON HEALTHCARE",
        "enumeration_date": "2014-11-05",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "KORTH-WHITE",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO EAST REIGON",
        "authorized_official_telephone_number": "989-348-0720"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230058",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayling, MI

Sources for this page

Verify at the official NPI Registry.