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Edward W Sparrow Hospital Association

Organization Active NPI Family Medicine Physician · Holt, MI

NPI 1437400413 · NPPES record last updated Mar 26, 2024

Key facts

NPI
1437400413
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
EDWARD W SPARROW HOSPITAL ASSOCIATION
Practice address
2040 Aurelius Rd Ste 22
Holt, MI 48842-1367
Phone
(517) 694-2217
Fax
(176) 942-6555
NPI assigned
Oct 1, 2012
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 with the same Medicare PAC ID 19

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

Practitioners 698

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 698

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130412000302 MI Part B Supplier - Clinic/Group Practice 6709799166 Receives reassigned benefits from 8 practitioners
Practice locations: Holt, MI

National Provider Directory

Part of
Sparrow Health System

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

2040 Aurelius Rd Ste 22
Holt, MI 48842-1367

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (517) 364-7999

Other names

  • SMG Holt Doing business as
  • University of Michigan Health-Sparrow Holt Primary Care Doing business as
  • University of Michigan Health-Sparrow Primary Care Doing business as

Other providers in Holt, MI

All providers in Holt, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.