NPIMap

Organization Active NPI

Edward W Sparrow Hospital Association

Doing business as Sparrow Medical Group General Surgery

  • Surgery Physician
  • Lansing, MI
National Provider Identifier
1457744666
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1060000091 Issued in MI
Legal business name
EDWARD W SPARROW HOSPITAL ASSOCIATION
Doing business as
Sparrow Medical Group General Surgery
University of Michigan Health-Sparrow General Surgery
Practice address
1200 E Michigan Ave Ste 775
Lansing, MI 48912-1838
Phone
(517) 364-5209
Fax
(517) 364-6204
NPI assigned
Mar 12, 2015
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
Phone
(517) 253-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 1060000091 MI Primary

Addresses

Primary practice location

1200 E Michigan Ave Ste 775
Lansing, MI 48912-1838

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (517) 364-6253

Other practice location 1

901 S Oakland St
Saint Johns, MI 48879-2255
Phone (517) 364-5388

Other names 2

  • Sparrow Medical Group General Surgery Doing business as
  • University of Michigan Health-Sparrow General Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150529000465 MI Part B Supplier - Clinic/Group Practice 6709799166 Receives reassigned benefits from 53 practitioners
2 other NPIs on this enrollment
Practice locations: Saint Johns, MI; Lansing, MI; East Lansing, 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 2

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

National Provider Directory

National Provider Directory
Part of
Sparrow Health System

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1457744666",
    "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": "517-364-6253",
            "fax_number": "517-364-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 775",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121838",
            "telephone_number": "517-364-5209",
            "fax_number": "517-364-6204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 S Oakland St",
            "address_purpose": "LOCATION",
            "city": "Saint Johns",
            "state": "MI",
            "postal_code": "488792255",
            "country_code": "US",
            "telephone_number": "517-364-5388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDWARD W SPARROW HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARROW HEALTH SYSTEM",
        "enumeration_date": "2015-03-12",
        "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",
        "authorized_official_telephone_number": "517-253-6308"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "1060000091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sparrow Medical Group General Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Michigan Health-Sparrow General Surgery",
            "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.