NPIMap

Organization Active NPI

Community Mental Health for Central Michigan

  • Psychiatry Physician
  • Mt Pleasant, MI
National Provider Identifier
1336462001
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
COMMUNITY MENTAL HEALTH FOR CENTRAL MICHIGAN
Practice address
301 S Crapo St
Suite 100
Mt Pleasant, MI 48858-2941
Phone
(989) 773-6961
Fax
(989) 953-4451
NPI assigned
Mar 9, 2010
Reactivated
Nov 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Authorized official

Name
John Obermesik
Title
Executive Director
Phone
(989) 772-5930

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X Primary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 364SP0808X

Addresses

Primary practice location

301 S Crapo St
Suite 100
Mt Pleasant, MI 48858-2941

Mailing address

301 S Crapo St
Suite 100
Mt Pleasant, MI 48858-2941
Phone (989) 773-6961

Other identifiers 2

IdentifierTypeStateIssuer
4344340MedicaidMI
4352754MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Community Mental Health for Central Michigan4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1336462001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S CRAPO ST",
            "address_2": "SUITE 100",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582941",
            "telephone_number": "989-773-6961",
            "fax_number": "989-953-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S CRAPO ST",
            "address_2": "SUITE 100",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582941",
            "telephone_number": "989-773-6961",
            "fax_number": "989-953-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MENTAL HEALTH FOR CENTRAL MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2018-11-30",
        "deactivation_date": "2018-11-23",
        "reactivation_date": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "OBERMESIK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "EXECUTIVE  DIRECTOR",
        "authorized_official_telephone_number": "989-772-5930"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4344340",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4352754",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.