Individual provider Active NPI

Christina Bambach

  • Nurse Practitioner
  • Marquette, MI
National Provider Identifier
1407136575
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704259419 Issued in MI
Practice address
2924 Parkview Dr
Marquette, MI 49855-8840
Phone
(906) 228-3575
NPI assigned
Aug 22, 2011
Last updated
Aug 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704259419 MI Primary

Addresses

Primary practice location

2924 Parkview Dr
Marquette, MI 49855-8840

Mailing address

2924 Parkview Dr
Marquette, MI 49855-8840
Phone (906) 228-3575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120327000752 MI Practitioner - Nurse Practitioner 3678733987 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schoolcraft Memorial HospitalGroup PAC ID 4082525118, 30 clinicians

Practice addresses (Care Compare)

7870W US Hwy 2
Manistique, MI 49854-8992
Phone (906) 341-2153

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704259419MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Walk-in Center, PC Current Accepting new patients
Schoolcraft Memorial Hospital CurrentSince Oct 20, 2021 Accepting new patients
Superior Walk-in Center, PC CurrentSince Feb 1, 2012 Accepting new patients

Locations

7870W US Highway 2
Manistique, MI 49854
Phone (906) 341-2153

1504 Sandpoint Rd
Munising, MI 49862
Phone (906) 387-4220

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1407136575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 PARKVIEW DR",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498558840",
            "telephone_number": "906-228-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 PARKVIEW DR",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498558840",
            "telephone_number": "906-228-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBACH",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704259419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.