Megan Wolbers, DO
Individual provider Active NPI General Practice Physician · Monroe, MI
NPI 1366067779 · NPPES record last updated Dec 27, 2023
Key facts
- NPI
- 1366067779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 5151014474 (MI)
- Practice address
- 718 N Macomb St
Monroe, MI 48162-7815 - Phone
- (734) 240-8400
- NPI assigned
- Jun 11, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Munson Healthcare Grayling
Practice addresses (Care Compare)
1250 E Michigan Ave
Grayling Community Health Center
Grayling, MI 49738-7074
Phone (989) 348-0550
Hospital & facility affiliations
- Munson Home Care
- Munson Healthcare Grayling Hospital
- Munson Healthcare Cadillac Hospital
- Munson Healthcare Otsego Memorial Hospital
- Kalkaska Memorial Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240109002725 | MI | Practitioner - Family Practice | 1759705841 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munson Medical Group | Family Medicine | Current | Accepting new patients |
| Munson Healthcare Grayling | Current | Accepting new patients | |
| Munson Healthcare Grayling | Family Medicine | Current |
Accepting new patients |
| Munson Healthcare Grayling | Current |
Accepting new patients | |
| Munson Healthcare Grayling | Past | Accepting new patients | |
| Munson Healthcare Grayling | Past | Accepting new patients |
Locations
3781 Momentum Pl
Chicago, IL 60689
1250 E Michigan Ave
Ste C
Grayling, MI 49738
Phone (989) 348-0550
1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550
1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
Interoperability endpoints
- mwolbers@direct.mhc.net
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61308
- https://fhir-myrecord.cerner.com/r4/d63001e8-2b2d-46b2-9b8b-4bc37428b829/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101027579 | MI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 5151014474 | MI | |
| General Practice Physician | 208D00000X | 5151014474 | MI | Yes |
Addresses
Primary practice location
718 N Macomb St
Monroe, MI 48162-7815
Mailing address
1130 Sanctuary Way
Temperance, MI 48182-9184
Other practice location 1
1250 E Michigan Ave
Grayling, MI 49738-7074
Phone (989) 348-0550
Other practice location 2
1250 E Michigan Ave Ste C
Grayling, MI 49738-7074
Phone (989) 348-0550
Other practice location 3
1100 E Michigan Ave
Grayling, MI 49738-1312
Phone (989) 348-5461
Other names
- Megan Ellis
NPI Registry JSON
{
"created_epoch": "1591833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1366067779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 SANCTUARY WAY",
"city": "TEMPERANCE",
"state": "MI",
"postal_code": "481829184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 N MACOMB ST",
"city": "MONROE",
"state": "MI",
"postal_code": "481627815",
"telephone_number": "734-240-8400"
}
],
"practiceLocations": [
{
"address_1": "1250 E Michigan Ave",
"address_purpose": "LOCATION",
"city": "Grayling",
"state": "MI",
"postal_code": "497387074",
"country_code": "US",
"telephone_number": "989-348-0550",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1250 E Michigan Ave Ste C",
"address_purpose": "LOCATION",
"city": "Grayling",
"state": "MI",
"postal_code": "497387074",
"country_code": "US",
"telephone_number": "989-348-0550",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 E Michigan Ave",
"address_purpose": "LOCATION",
"city": "Grayling",
"state": "MI",
"postal_code": "497381312",
"country_code": "US",
"telephone_number": "989-348-5461",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLBERS",
"first_name": "MEGAN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-11",
"last_updated": "2023-12-27",
"certification_date": "2023-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101027579",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "5151014474",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "5151014474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MEGAN",
"last_name": "ELLIS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Monroe, MI
- Catherine Jean Witherow
- Aaron T Witt
- Ross Witte II
- Paige Wittler
- Megan Witz
- Suzanne Elizabeth Wolfe
- Women Empowering Women, Inc.
- Erica Wood
- Stephanie Woodruff
- Kim Woods
All providers in Monroe, MI · General Practice 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 Dec 27, 2023. 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.
- Order and Referring (CMS).
- 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.