Sparrow Carson Hospital
Organization Active NPI Anesthesiology Physician · Carson City, MI
NPI 1396789798 · NPPES record last updated Apr 5, 2024
Key facts
- NPI
- 1396789798
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- SPARROW CARSON HOSPITAL
- Practice address
- 406 E Elm St
Carson City, MI 48811-9693 - Phone
- (989) 584-3971
- NPI assigned
- Jun 15, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARROW HEALTH SYSTEM
Authorized official
- Name
- Misty Gunter Russian
- Title
- Supervisor, Provider Enrollment
- Phone
- (517) 253-6308
Other NPIs on the same Medicare enrollment 20
Other NPIs with the same Medicare PAC ID 7
Member of 1
Practitioners 116
-
Iftiker Ahmad, MD
-
Ashley Lynn Maiville, FNP-C
-
Ryan Mui, DO
-
Pamela Elizabeth Stave, PA-C
-
Brian Michael Howe, CRNA
-
Kimberly Jane Lapham, CRNA
-
Sally Range, CRNA
-
Luke Anthony Rohlfs, CRNA
-
Deloris K Vanderhoof, CRNA
-
Anshu Wadehra, MD
-
Asad Iqbal Mehboob, D.O.
-
Chelsea N Barnes, FNP-C
-
Parut R Bhimalli, MD
-
Eric J Egeler, M.D.
-
Eric Lee Larson, MD
-
Wanda Kay Myers, NP
-
Michael A Okkerse, CRNA
-
Trevor Peterson, MD
-
Ross Tanzer, D.O.
-
Nancy A Weaver, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040126000046 | MI | Part B Supplier - Clinic/Group Practice | 7113836701 |
Receives reassigned benefits from 241 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Greenville, MI; Stanton, MI; Mount Pleasant, MI; Ithaca, MI; Fowler, MI; Carson City, MI |
| O20040527000622 | MI | Part B Supplier - Clinic/Group Practice | 7113836701 |
Receives reassigned benefits from 22 practitioners 1 other NPI on this enrollment Practice locations: Carson City, MI |
National Provider Directory
- Part of
- Sparrow Health System
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Interventional Pain Medicine Physician |
208VP0014X | |||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
406 E Elm St
Carson City, MI 48811-9693
Mailing address
8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (989) 584-3971
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430E910280 | Other | MI | BCBS CRNAS |
| 368419900 | Other | MI | USDOL |
| 050E910250 | Other | MI | BCBS ANESTHESIOLOGISTS |
Other names
- University of Michigan Health-Sparrow
- Sparrow Medical Group Pain Management Carson City
- University of Michigan Health-Sparrow Carson Pain Management
Other providers in Carson City, MI
- Deanna L Small
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
- Sparrow Carson Hospital
All providers in Carson City, MI · Anesthesiology 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 Apr 5, 2024. 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.