Central Michigan District Health Department

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT

Practice address

2012 E Preston Ave
Mount Pleasant, MI 48858-8990

Phone

(989) 773-5921

Fax

(989) 773-4319

NPI assigned

May 17, 2006

Last updated

Oct 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven C Hall

Title

Health Officer

Phone

(989) 773-5921

Specialties & licenses 2

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 23

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.

• Mary Ellen Boudreau, NP (AGPCNP-BC)

  • Primary Care Nurse Practitioner
  • Mason, MI
  • NPI 1730523598
  Medicare reassignment Care Compare group NPD
• Amanda Fetterolf, MSN, FNP-BC

  • Family Nurse Practitioner
  • Harrison, MI
  • NPI 1518528710
  Medicare reassignment Care Compare group NPD
• Jamie Stevenson, FNP-C

  • Family Nurse Practitioner
  • Saginaw, MI
  • NPI 1467145243
  Medicare reassignment Care Compare group NPD
• Shannon Adams, FNP

  • Family Nurse Practitioner
  • Midland, MI
  • NPI 1245999168
  Medicare reassignment Care Compare group
• Peter Gregory Gulick, D.O.

  • Infectious Disease Physician
  • Lansing, MI
  • NPI 1255383238
  Medicare reassignment Care Compare group
• Jennifer E Morse, MD

  • Family Medicine Physician
  • Mt Pleasant, MI
  • NPI 1801805536
  Medicare reassignment Care Compare group
• Rachel Peterson, FNP

  • Family Nurse Practitioner
  • Saginaw, MI
  • NPI 1447734017
  Medicare reassignment NPD
• Leyda M Su Ham, D.O.

  • Family Medicine Physician
  • Cudahy, WI
  • NPI 1912169657

  MI

  Medicare reassignment NPD
• Jessika Evelyn Doyle, LMSW

  • Clinical Social Worker
  • Sanford, MI
  • NPI 1225693922
  Medicare reassignment
• Amber Jones, CHW

  • Community Health Worker
  • Mt Pleasant, MI
  • NPI 1093585028
  NPD
• Erika Breault, CHW

  • Community Health Worker
  • Gladwin, MI
  • NPI 1962272575
  NPD (past)
• Alexandra Kate Cameron, RDN

  • Registered Dietitian
  • Prudenville, MI
  • NPI 1447805312
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1245283977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 E PRESTON AVE",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488588990",
            "telephone_number": "989-773-5921",
            "fax_number": "989-773-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 E PRESTON AVE",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488588990",
            "telephone_number": "989-773-5921",
            "fax_number": "989-773-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MICHIGAN DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "989-773-5921"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100170",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100205",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830361",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830352",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830399",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830405",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830423",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100199",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830343",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2830370",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1862235",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100152",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100161",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100214",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Michigan Audiology LLC (Allied Hearing)
• Central Michigan Care Inc
• Central Michigan Care, Inc.
• Central Michigan Community Hospital Radiation Oncology
• Central Michigan Community Hospital Radiation Oncology
• Central Michigan Family Chiropractic Clinic PLC
• Central Michigan Family Dentistry, PLLC (Dr. Derrek Henrie)
• Central Michigan Guardianship Incorporated
• Central Michigan Hand Therapy LLC
• Central Michigan Headache and Neurology PC

• Public Health or Welfare Agency in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Public Health or Welfare Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.