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Munson Healthcare Grayling

Organization Active NPI Rural Acute Care Hospital · Grayling, MI

NPI 1083010953 · NPPES record last updated Aug 20, 2024

Key facts

NPI
1083010953
Entity type
Organization (NPI type 2)
Primary specialty
Rural Acute Care Hospital 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
Organization subpart
Yes
Parent organization (as reported)
MUNSON HEALTHCARE

Authorized official

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 10

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

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

Facilities with the same owner 24

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

Practitioners 80

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 80

Affiliated clinicians 368

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

View all 368

Medicare Care Compare: Hospital

Listed as
Munson Healthcare Grayling Hospital CCN 230058
Overall star rating
★★★☆☆ 3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

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
Corporation · Non-profit
Incorporated
Jun 17, 2014 in MI
Enrollment address
1100E Michigan Ave
Grayling, MI 49738-1312
Hospital subgroups
Acute care

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 Officer
Trustee		 Jan 1, 2024
Ruth Hoppe
Individual 		Corporate Officer Jan 1, 2022
Paul Konopacki
Individual 		Corporate Officer
Cfo		 Jan 1, 2024
Vincent Schultz
Individual 		Corporate Officer
Trustee		 Jan 1, 2024
Thomas Veryser
Individual 		Corporate Officer
Trustee		 Jan 1, 2022
Kenneth D Bloem
Individual 		Corporate Officer Jan 1, 2022
Timothy Nelson
Individual 		Corporate Officer Jan 1, 2022
David Menegebier
Individual 		Corporate Officer
Trustee		 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 Director
President/Ceo		 Nov 30, 2023 100%
Mary Sanders
Individual 		Corporate Officer Jan 1, 2022
Elaine Wood
Individual 		Corporate Officer
Trustee		 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 Director
Trustee		 Feb 1, 2015
W-2 Managing Employee Jan 1, 2022
Owen Roberts
Individual 		Corporate Officer Jan 1, 2022
Bruce Zenner
Individual 		Corporate Officer
Trustee		 Jan 1, 2022
Sakura Takano
Individual 		Corporate Officer
Trustee		 Jan 1, 2022
Kristine Thomas
Individual 		Corporate Officer
Trustee		 Jan 1, 2022
Brian Postma
Individual 		Corporate Officer Jan 1, 2022
Dino Recchia
Individual 		Corporate Officer
Trustee		 Jan 1, 2024
Jennifer King
Individual 		Corporate Officer
Trustee		 Jan 1, 2024

Medicare enrollment records

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

National Provider Directory

Tax ID family
Munson Healthcare Grayling (11 organizations share this tax ID)
Part of
Munson Manor Hospitality House

Interoperability endpoints

  • Direct secure messaging: medrecgry@direct.mhc.net
  • 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: mhc.crawfordschoolproviderservices@direct.mhc.net

Specialties & licenses

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

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

IdentifierTypeStateIssuer
230058MedicaidMI
00030OtherMIBCBS

Other providers in Grayling, MI

All providers in Grayling, MI · Rural Acute Care Hospital in Michigan

Sources for this page

Verify at the official NPI Registry.