NPIMap

Organization Active NPI

Edward W. Sparrow Hospital Association

Doing business as Sparrow Medical Group Lansing

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1427004183
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EDWARD W. SPARROW HOSPITAL ASSOCIATION
Doing business as
Sparrow Medical Group Lansing
University of Michigan Health-Sparrow Michigan Ave Primary Care
University of Michigan Health-Sparrow Primary Care
Practice address
1200 E Michigan Ave
Suite 325
Lansing, MI 48912-1800
Phone
(517) 364-5160
Fax
(517) 364-5165
NPI assigned
May 25, 2006
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARROW HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Misty Gunter Russian
Title
Supervisor, Provider Enrollment
Phone
(517) 253-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1200 E Michigan Ave
Suite 325
Lansing, MI 48912-1800

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (517) 364-5160

Other identifiers 1

IdentifierTypeStateIssuer
080C311160OtherMIBCBS GROUP NUMBER

Other names 3

  • Sparrow Medical Group Lansing Doing business as
  • University of Michigan Health-Sparrow Michigan Ave Primary Care Doing business as
  • University of Michigan Health-Sparrow Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040102000790 MI Part B Supplier - Clinic/Group Practice 6709799166 Receives reassigned benefits from 965 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lansing, MI; Mason, MI; Okemos, MI; Owosso, MI; Saint Johns, MI; Williamston, MI; Carson City, MI; Charlotte, MI…

Other NPIs on the same Medicare enrollment 34

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

View all 34

National Provider Directory

National Provider Directory
Part of
Sparrow Health System

Locations

1600 W Grand River Ave
Ste 4
Okemos, MI 48864
Phone (517) 381-6880

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1427004183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860081",
            "telephone_number": "517-364-5160",
            "fax_number": "517-364-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE",
            "address_2": "SUITE 325",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121800",
            "telephone_number": "517-364-5160",
            "fax_number": "517-364-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD W. SPARROW HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARROW HEALTH SYSTEM",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "RUSSIAN",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "GUNTER",
        "authorized_official_title_or_position": "SUPERVISOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "517-253-6308"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "080C311160",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sparrow Medical Group Lansing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Michigan Health-Sparrow Michigan Ave Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Michigan Health-Sparrow Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.