NPIMap

Organization Active NPI

Edward W. Sparrow Hospital Association

Doing business as Sparrow Medical Group Mason

  • Family Medicine Physician
  • Mason, MI
National Provider Identifier
1437331501
Registry record updated Mar 27, 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 Mason
University of Michigan Health-Sparrow Mason Primary Care
University of Michigan Health-Sparrow Primary Care
Practice address
230 Temple St
Mason, MI 48854-1837
Phone
(517) 676-9066
Fax
(517) 676-3505
NPI assigned
Nov 30, 2007
Last updated
Mar 27, 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 27, 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

230 Temple St
Mason, MI 48854-1837

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (517) 676-9066

Other identifiers 1

IdentifierTypeStateIssuer
70-0-C3-0154-0OtherMIBCBS GROUP NUMBER

Other names 3

  • Sparrow Medical Group Mason Doing business as
  • University of Michigan Health-Sparrow Mason 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
O20080219000111 MI Part B Supplier - Clinic/Group Practice 6709799166 Receives reassigned benefits from 26 practitioners
2 other NPIs on this enrollment
Practice locations: Owosso, MI; Mason, MI; Okemos, MI

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Jan Q Wu MD49 organizations share this tax ID, including this one
Part of
Sparrow Health System

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

Locations

2446 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 253-5530

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1437331501",
    "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": "517-676-9066",
            "fax_number": "517-676-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 TEMPLE ST",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541837",
            "telephone_number": "517-676-9066",
            "fax_number": "517-676-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD W. SPARROW HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARROW HEALTH SYSTEM",
        "enumeration_date": "2007-11-30",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "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": "70-0-C3-0154-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sparrow Medical Group Mason",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Michigan Health-Sparrow Mason 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 Mason, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.