NPIMap

Organization Active NPI

Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Mio, MI
National Provider Identifier
1093349698
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MUNSON HEALTHCARE GRAYLING
Practice address
1321 S Mount Tom Rd
Mio, MI 48647-9518
Phone
(989) 344-5820
Fax
(231) 392-7338
NPI assigned
Feb 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Authorized official

Name
Michael Frye, MD
Title
Pres. Ambulatory & Bus. Development
Phone
(704) 458-8010

Specialties & licenses 1

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

Addresses

Primary practice location

1321 S Mount Tom Rd
Mio, MI 48647-9518

Mailing address

1321 S Mount Tom Rd
Mio, MI 48647-9518
Phone (989) 344-5820

Other names 1

  • Mio Primary Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150326000110 MI Part B Supplier - Clinic/Group Practice 2062736655 Receives reassigned benefits from 139 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grayling, MI; Roscommon, MI; Prudenville, MI; Mio, MI
O20200821002000 MI Part A Provider - Rural Health Clinic 2062736655 Practice locations: Mio, MI

Rural health clinic certification: CCN 238726

Legal name
MUNSON HEALTHCARE GRAYLING
Doing business as
MUNSON HEALTHCARE MIO PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 30, 2020
Last certification
Dec 30, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 17, 2014 in MI
Enrollment address
1321 S Mount Tom Rd
Mio, MI 48647-9518
Related CCNs
230058

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).

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: mhc.mioobgyn@direct.mhc.net
  • Direct secure messaging: mhc.mioprimarycare@direct.mhc.net
  • Direct secure messaging: ebuchler@direct.mhc.net

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Gregg B Hanert Individual W-2 Managing EmployeeMD; Jan 1, 2016
Andrew Page Individual Corporate OfficerTrustee Jan 1, 2024
Ruth Hoppe Individual Corporate DirectorSecretary Jan 1, 2022
Paul Konopacki Individual Corporate OfficerCfo Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
Operational/Managerial ControlCfo Jan 1, 2024
Vincent Schultz Individual Corporate OfficerTrustee Jan 1, 2024
Thomas Veryser Individual Corporate OfficerTrustee Jan 1, 2022
Kenneth D Bloem Individual Corporate DirectorVice Chair Jan 1, 2022
Timothy Nelson Individual Corporate DirectorTreasurer Jan 1, 2022
David Menegebier Individual Corporate OfficerTrustee Jan 1, 2024
Edward Lanphier Individual Corporate Director Jan 1, 2026
Kathy Dixon Individual Corporate DirectorTrustee Jan 1, 2022
Kirsten Bethany Korth-White Individual Corporate OfficerPresident Sep 4, 2018
Corporate Director Nov 30, 2023 100%
W-2 Managing Employee Nov 30, 2023 100%
Mary Sanders Individual Corporate OfficerTrustee Jan 1, 2022
Elaine Wood Individual Corporate DirectorChair Jan 1, 2022
Claudia Rowland Individual Corporate Director Jan 1, 2026
Munson Healthcare Organization, Traverse City, MI Corporation, Non-profit Operational/Managerial Control Feb 1, 2015
Edwin a Ness Individual Corporate DirectorBoard Member Aug 1, 2018
Owen Roberts Individual Corporate OfficerTrustee 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 OfficerTrustee 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 3

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 110

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

View all 110

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1093349698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 S MOUNT TOM RD",
            "city": "MIO",
            "state": "MI",
            "postal_code": "486479518",
            "telephone_number": "989-344-5820",
            "fax_number": "231-392-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 S MOUNT TOM RD",
            "city": "MIO",
            "state": "MI",
            "postal_code": "486479518",
            "telephone_number": "989-344-5820",
            "fax_number": "231-392-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE GRAYLING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-24",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "FRYE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRES. AMBULATORY & BUS. DEVELOPMENT",
        "authorized_official_telephone_number": "704-458-8010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mio Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mio Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mio, MI

Sources for this page

Verify at the official NPI Registry.