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Munson Healthcare Charlevoix Hospital

Organization Active NPI Rural Health Clinic/Center · Boyne City, MI

NPI 1255779484 · NPPES record last updated Apr 17, 2026

Key facts

NPI
1255779484
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Practice address
223 N Park St
Boyne City, MI 49712-1220
Phone
(231) 582-5314
Fax
(231) 582-5338
NPI assigned
Jun 10, 2013
Organization subpart
Yes
Parent organization (as reported)
MUNSON HEALTHCARE

Authorized official

Name
Michael Frye, MD
Title
President Amb & Bus Development
Phone
(704) 458-8010

Owners & managing parties with NPI records 2

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

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 7

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

Other NPIs with the same Medicare PAC ID 5

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

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 75

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

View all 75

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in MI

Rural health clinic certification: CCN 238665

Legal name
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Doing business as
BOYNE AREA MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 13, 2014
Last certification
May 13, 2014
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Enrollment address
223 N Park St
Boyne City, MI 49712-1220
Related CCNs
231322

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
Kimberly Morley
Individual 		Other Jan 1, 2022
Andrew Page
Individual 		Corporate Officer
Trustee		 Jan 1, 2024
Ruth Hoppe
Individual 		Other Jan 1, 2022
Paul Konopacki
Individual 		Corporate Officer
Cfo		 Jan 1, 2024
W-2 Managing Employee
Cfo		 Jan 1, 2024
Operational/Managerial Control
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 		Other Jan 1, 2022
Timothy Nelson
Individual 		Other Jan 1, 2022
David Menegebier
Individual 		Corporate Officer
Trustee		 Jan 1, 2024
Nicholas E Ceglarek
Individual 		Other Jan 1, 2022
Kathy Dixon
Individual 		Other Jan 1, 2022
Kirsten Bethany Korth-White
Individual 		Corporate Director
President/Ceo		 Jan 23, 2024 100%
W-2 Managing Employee
President/Ceo		 Jan 23, 2024 100%
Mary Sanders
Individual 		Corporate Officer
Trustee		 Jan 1, 2022
Elaine Wood
Individual 		Corporate Officer
Trustee		 Jan 1, 2022
Munson Healthcare
Organization · Traverse City, MI
Corporation 		Operational/Managerial Control Dec 1, 2015 100%
Edwin a Ness
Individual 		Corporate Director
Ceo		 Feb 15, 2015
Owen Roberts
Individual 		Corporate Officer
Trustee		 Jan 1, 2022
Matthew Bulloch
Individual 		Corporate Officer
Trustee		 Jan 1, 2023
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
Trustee		 Jan 1, 2022
Dino Recchia
Individual 		Corporate Officer
Trustee		 Jan 1, 2024
Jennifer King
Individual 		Corporate Officer
Trustee		 Jan 1, 2024

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Boulder Park Terrace
Charlevoix, MI · CCN 235526		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (25%) Jun 10, 1992

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040211001170 MI Part B Supplier - Clinic/Group Practice 4284528035 Receives reassigned benefits from 98 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlevoix, MI; East Jordan, MI
O20070109000030 MI Part B Supplier - Clinic/Group Practice 4284528035 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlevoix, MI; Traverse City, MI; Manistee, MI; Kalkaska, MI; Grayling, MI; Gaylord, MI; Frankfort, MI; Cadillac, MI…
O20130722000040 MI Part a Provider - Rural Health Clinic 4284528035 Practice locations: Boyne City, MI

National Provider Directory

Part of
Munson Manor Hospitality House

Locations

223 N Park St
Boyne City, MI 49712
Phone (231) 582-5314

14695 Park Ave
Ste B
Charlevoix, MI 49720
Phone (231) 547-8860

Specialties & licenses

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

Addresses

Primary practice location

223 N Park St
Boyne City, MI 49712-1220

Mailing address

223 N Park St
Boyne City, MI 49712-1220
Phone (231) 582-5314

Other names

  • Munson Healthcare Boyne Area Medical Center Doing business as

Other providers in Boyne City, MI

All providers in Boyne City, MI · Rural Health Clinic/Center in Michigan

Sources for this page

Verify at the official NPI Registry.