Marlette Regional Hospital
Organization Active NPI Family Medicine Physician · Marlette, MI
NPI 1225495013 · NPPES record last updated Mar 6, 2024
Key facts
- NPI
- 1225495013
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- MARLETTE REGIONAL HOSPITAL
- Practice address
- 2750 Main St
Marlette, MI 48453-1100 - Phone
- (989) 635-1840
- Fax
- (989) 635-4056
- NPI assigned
- Jan 25, 2016
- Organization subpart
- No
Authorized official
- Name
- Mrs. Angela McConnachie
- Title
- Ceo
- Phone
- (989) 635-4000
Owners & managing parties with NPI records 1
-
Carol L Starling, OD
Other NPIs on the same Medicare enrollment 6
Related certifications (CCN) 4
Practitioners 30
-
Faraaz Ahmed, MD
-
Mohomad Al Sawah, DPM
-
Amer M Alame, M.D.
-
Majed Alzahabi, DO
-
Paul Ariagno, MD
-
Alex Dandashly, DPM
-
Michael Naeim Henein, M.D.
-
Clayton Donald House, FNP-C
-
Jennifer C Jones, FNP-C
-
Sanjeev A Kaul, M.D., MCH
-
David W Lemos, MD
-
Shahzad Manawar, M.D.
-
Allison Nichol, D.O., ATC
-
Donald H Robbins Jr., D.O.
-
Kimberly L Verellen, PA-C
-
Mark Ashraf Boules, M.D.
Affiliated clinicians 131
-
Faraaz Ahmed, MD
-
Khalid Al Efraij, MBBS
-
Abdul Kadar Alawwa, M.D.
-
Syed V Ali, MD
-
Rashid Alsabeh, M.D.
-
Farrukh Anwar, MD
-
Paul Ariagno, MD
-
Sydney Collins Arnold, PA-C
-
Ronald A Bays, MD
-
Donald D Berry, PA
-
Neal Bhatt, M.D.
-
John E Bitner, MD
-
Tara Lynn Blank, PA-C
-
Makayla Linn Brindley, FNP-BC
-
Gregory Brown, PA-C
-
John M Buday, M.D.
-
Nick Buttar, M.D.
-
Joseph Nino Carlier, D.O.
-
Randy M Chudler, MD
-
Tyler Conway, MD
Medicare Care Compare: Hospital
- Listed as
- Marlette Regional Hospital
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Hospital certification: CCN 231330
- Legal name
- MARLETTE REGIONAL HOSPITAL
- Doing business as
- MARLETTE REGIONAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Sep 1, 2005
- Last certification
- Oct 7, 2005
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 2770 Main St
Marlette, MI 48453-1141
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Carol L Starling |
Corporate Director |
Jan 1, 2024 | |
| Faith Ann Fahrner |
Corporate Director |
Jan 1, 2024 | |
| Bluewater Healthcare Network |
Operational/Managerial Control | Dec 28, 2012 | |
| Patrick D Curtis |
Corporate Director |
Jan 1, 2024 | |
| Kimberly Gentner |
Corporate Officer |
Jan 1, 2024 | |
| W-2 Managing Employee |
Jan 1, 2024 | ||
| Steven Ellis |
Corporate Director |
Jan 1, 2024 | |
| Victoria Meiburg |
Corporate Director |
May 10, 2022 | |
| Gail Ann Denton |
Corporate Director |
May 9, 2016 | |
| Judy K Brown |
Corporate Director |
Jan 1, 2024 | |
| Angela McConnachie |
Corporate Director | Jan 1, 2023 | |
| W-2 Managing Employee | Jan 1, 2023 | ||
| Scott Orr |
Corporate Director |
Nov 2, 2009 | |
| Paul Rohling |
Corporate Director |
Jan 1, 2024 | |
| Andrew Joseph Daniels |
Corporate Officer |
Jan 1, 2024 | |
| W-2 Managing Employee |
Jan 1, 2024 | ||
| Erik Tamlyn |
Corporate Director |
Jan 1, 2024 | |
| David Messing |
Corporate Director |
Oct 9, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031202000143 | MI | Part B Supplier - Clinic/Group Practice | 3971408121 |
Receives reassigned benefits from 39 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Brown City, MI; Marlette, MI |
| O20070223000678 | MI | Part a Provider - Critical Access Hospital | 3971408121 |
Receives reassigned benefits from 164 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Marlette, MI |
National Provider Directory
Locations
2750 Main St
Marlette, MI 48453
Phone (989) 635-4002
2750 Main St
Ste 78
Marlette, MI 48453
Phone (989) 635-1840
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Orthopaedic Surgery Physician |
207X00000X |
Addresses
Primary practice location
2750 Main St
Marlette, MI 48453-1100
Mailing address
2770 Main St
PO Box 307
Marlette, MI 48453-1141
Phone (989) 635-4000
Other providers in Marlette, MI
- Marlette Regional Hospital
- Marlette Regional Hospital
- Marlette Regional Hospital
- Marlette Regional Hospital
- Marlette Regional Hospital
- Marlette Regional Hospital
- Marlette Regional Hospital
- Marlette Regional Hospital
- Marlette Regional Hospital
- Marlette Regional Hospital
All providers in Marlette, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.