Thunder Bay Community Health Service, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

THUNDER BAY COMMUNITY HEALTH SERVICE, INC

Doing business as

Presque Isle Academy II

Practice address

20830 Cedar Street
Onaway, MI 49765-0731

Phone

(989) 354-2197

Fax

(989) 356-6524

NPI assigned

Jul 1, 2015

Last updated

Nov 18, 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

Michelle Styma

Title

Ceo

Phone

(989) 742-4583

Specialties & licenses 1

Addresses

Other names 1

• Presque Isle Academy II Doing business as

Locations

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1366825879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 427",
            "city": "HILLMAN",
            "state": "MI",
            "postal_code": "497460427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20830 CEDAR STREET",
            "city": "ONAWAY",
            "state": "MI",
            "postal_code": "497650731",
            "telephone_number": "989-354-2197",
            "fax_number": "989-356-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THUNDER BAY COMMUNITY HEALTH SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "STYMA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "989-742-4583"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presque Isle Academy II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elaine C Smith, DO
• Amanda S Stein, RDH
• Sarah Elizabeth Straley, PA-C
• Prerna Suri, DDS
• Theodore Reahm DO, PLC
• Thunder Bay Community Health Service, Inc
• Thunder Bay Community Health Service, Inc
• Thunder Bay Community Health Service, Inc. (Thunder Bay Pharmacy Onaway)
• Thunder Bay Community Health Service, Inc.
• Lindsay Ann Walker, LLMSW

• Federally Qualified Health Center (FQHC) in Onaway, MI
• Providers in Onaway, MI by specialty
• Federally Qualified Health Center (FQHC) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.