NPIMap

Organization Active NPI

Grand Traverse Band of Ottawa and Chippewa Indians

  • Psychiatric/Mental Health Registered Nurse
  • Peshawbestown, MI
National Provider Identifier
1477227239
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
Legal business name
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Practice address
2300 N. Stallman Rd.
Peshawbestown, MI 49682-9275
Phone
(231) 534-0709
NPI assigned
Aug 5, 2021
Organization subpart
Yes
Parent organization
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Authorized official

Name
Mrs. Rebecca Lynn Oien, MOAM
Title
Tribal Manager
Phone
(231) 534-7136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X Primary

Addresses

Primary practice location

2300 N. Stallman Rd.
Peshawbestown, MI 49682-9275

Mailing address

2605 N. West Bay Shore Dr
Peshaebestown, MI 49682-9275
Phone (231) 534-0709

Other names 1

  • Grand Traverse Band Behavioral Health Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Grand Traverse Band of Ottawa and Chippewa Indians3 organizations share this tax ID, including this one
Part of
Grand Traverse Band of Ottawa and Chippewa Indians

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1477227239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N. WEST BAY SHORE DR",
            "city": "PESHAEBESTOWN",
            "state": "MI",
            "postal_code": "496829275",
            "telephone_number": "231-534-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N. STALLMAN RD.",
            "city": "PESHAWBESTOWN",
            "state": "MI",
            "postal_code": "496829275",
            "telephone_number": "231-534-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "OIEN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "TRIBAL MANAGER",
        "authorized_official_telephone_number": "231-534-7136",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MOAM"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Traverse Band Behavioral Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peshawbestown, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.