Organization Active NPI

Mymichigan Medical Center Standish

  • Family Medicine Physician
  • Standish, MI
National Provider Identifier
1144779885
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MYMICHIGAN MEDICAL CENTER STANDISH
Practice address
805 W Cedar St
Standish, MI 48658-9526
Phone
(989) 846-3503
Fax
(989) 846-3536
NPI assigned
Sep 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

805 W Cedar St
Standish, MI 48658-9526

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000

Other names 1

  • Ascension Standish Hospital Healthcare Associates of Standish Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120114000064 MI Part B Supplier - Clinic/Group Practice 0840362224 Receives reassigned benefits from 16 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Standish, MI

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1144779885",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W CEDAR ST",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486589526",
            "telephone_number": "989-846-3503",
            "fax_number": "989-846-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMICHIGAN MEDICAL CENTER STANDISH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Standish Hospital Healthcare Associates of Standish",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Standish, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.