Kalkaska Memorial Health Center
Organization Active NPI Family Medicine Physician · Kalkaska, MI
NPI 1376799650 · NPPES record last updated Nov 7, 2023
Key facts
- NPI
- 1376799650
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- KALKASKA MEMORIAL HEALTH CENTER
- Practice address
- 419 S Coral St
Kalkaska, MI 49646-2503 - Phone
- (231) 258-7500
- Fax
- (231) 258-7527
- NPI assigned
- Aug 18, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Andrew Richard Raymond, FACHE
- Title
- Ceo
- Phone
- (231) 258-3651
Other NPIs on the same Medicare enrollment 6
Practitioners 44
-
David Thomas Auer, PA-C
-
Andrew S Boyce, MD
-
Eric Covert, PA-C
-
Maria I Cupp, PA-C
-
Bruce Daman, NP
-
Michael Delaney, M.D.
-
Keith W Eaton, M.D.
-
Marissa Fischer, PA-C
-
Brian D Heeringa, MD
-
Jason T Hicks, PCC
-
Anthony Craig Hockin, PHD
-
Richard E Hodgman, M.D.
-
Jeremy K Holmes, DO
-
Sharon Marie Johnson, P.A.-C
-
Lori Ann Lemonnier, M.D.
-
Stephanie D Markle, D.O
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040813000668 | MI | Part B Supplier - Clinic/Group Practice | 3577536002 |
Receives reassigned benefits from 111 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kalkaska, MI; Mancelona, MI |
National Provider Directory
Interoperability endpoints
- llemonnier@direct.mhc.net
- dauer2@direct.mhc.net
- spillay@direct.mhc.net
- csheerin@direct.mhc.net
- jstych@direct.mhc.net
- dspencer2@direct.mhc.net
- jholmes@direct.mhc.net
- mfischer2@direct.mhc.net
- heves2@direct.mhc.net
- dgentry@direct.mhc.net
- ahockin@direct.mhc.net
- wmervau2@direct.mhc.net
- mcupp2@direct.mhc.net
- wnowak@direct.mhc.net
- jpolanic@direct.mhc.net
- sjohnson8@direct.mhc.net
- mhc.kalkaskamedicalassociates@direct.mhc.net
- acole4@direct.mhc.net
- tminor@direct.mhc.net
- rhodgman@direct.mhc.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Gastroenterology Physician |
207RG0100X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Trauma Physician |
207XX0801X | |||
| Otolaryngology Physician |
207Y00000X | |||
| Pediatrics Physician |
208000000X | |||
| Pain Medicine (Physical Medicine & Rehabilitation) Physician |
2081P2900X | |||
| Surgery Physician |
208600000X | |||
| Foot & Ankle Surgery Podiatrist |
213ES0103X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X | |||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
419 S Coral St
Kalkaska, MI 49646-2503
Mailing address
419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500
Other providers in Kalkaska, MI
- Kalkaska Family Practice PC
- Kalkaska Memorial Health Center
- Kalkaska Memorial Health Center
- Kalkaska Memorial Health Center
- Kalkaska Memorial Health Center
- Kalkaska Memorial Health Center
- Kalkaska Memorial Health Center
- Kalkaska Memorial Health Center
- Kathryn Mancewicz LLC
- Emmaline Keely-Luhellier
All providers in Kalkaska, MI · Family Medicine 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 Nov 7, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.