MHSN Roscommon Mpca

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MHSN ROSCOMMON MPCA

Practice address

234 Lake St
Roscommon, MI 48653-9203

Phone

(989) 275-1200

NPI assigned

Sep 24, 2008

Last updated

Sep 24, 2008By 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

Stephanie Riemer-Matuzak

Title

Chief Executive Officer

Phone

(989) 348-5461

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1306096516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 647",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497380647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 LAKE ST",
            "city": "ROSCOMMON",
            "state": "MI",
            "postal_code": "486539203",
            "telephone_number": "989-275-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MHSN ROSCOMMON MPCA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "RIEMER-MATUZAK",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "989-348-5461"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Derousse Counseling, LLC
• Douglas C Mackintosh, PT
• Tara Mallory
• Kalli Martin
• Mercy Hospital Grayling (Mercy Family Care Roscommon)
• MHSN Roscommon Mpca
• Midmichigan Health Services (Northern Michigan Children's Assessment Center)
• Midmichigan Health Services (MidMichigan Health Services Gerrish Higgins Community Schools)
• Midmichigan Health Services (MidMichigan Medical Offices - Roscommon)
• Midmichigan Health Services (MidMichigan Community Health Services)

• Family Medicine Physician in Roscommon, MI
• Providers in Roscommon, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.