NPIMap

Organization Active NPI

Munson Healthcare Charlevoix Hospital

  • Certified Registered Nurse Anesthetist
  • Charlevoix, MI
National Provider Identifier
1417033143
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Practice address
14700 Lake Shore Drive
Charlevoix, MI 49720-1931
Phone
(231) 547-4024
Fax
(231) 547-8088
NPI assigned
Oct 27, 2006
Last updated
Apr 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MUNSON HEALTHCARE CHARLEVOIX HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Michael Frye, MD
Title
Pres. Ambulatory & Bus. Development
Phone
(704) 458-8010

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary
Emergency Medicine Physician 207P00000X
Medical Oncology Physician 207RX0202X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

14700 Lake Shore Drive
Charlevoix, MI 49720-1931

Mailing address

14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone (231) 547-4024

Other identifiers 7

IdentifierTypeStateIssuer
134141100OtherMICOMP CARRIER US POSTAL SV
700A560010OtherMIBCN PROFESSINAL MULTI GRP
CAOtherMIJVHL
CD9821OtherMEDICARE RAILROAD GROUP
1001019OtherMINORTHERN HEALTH PLAN
700A560010OtherMIBCBS MULTI GROUP
20139OtherMIPRIORITY HEALTH PROFESSIO

Other names 1

  • Multi-Specialty Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211001170 MI Part B Supplier - Clinic/Group Practice 4284528035 Receives reassigned benefits from 98 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charlevoix, MI; East Jordan, MI

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Charlevoix Area Hosptia

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1417033143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-4024",
            "fax_number": "231-547-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 LAKE SHORE DRIVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201931",
            "telephone_number": "231-547-4024",
            "fax_number": "231-547-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE CHARLEVOIX HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUNSON HEALTHCARE CHARLEVOIX HOSPITAL",
        "enumeration_date": "2006-10-27",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "FRYE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRES. AMBULATORY & BUS. DEVELOPMENT",
        "authorized_official_telephone_number": "704-458-8010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMP CARRIER US POSTAL SV",
            "identifier": "134141100",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN PROFESSINAL MULTI GRP",
            "identifier": "700A560010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JVHL",
            "identifier": "CA",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP",
            "identifier": "CD9821",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHERN HEALTH PLAN",
            "identifier": "1001019",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MULTI GROUP",
            "identifier": "700A560010",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH PROFESSIO",
            "identifier": "20139",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Multi-Specialty Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlevoix, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.