Munson Healthcare Cadillac

Organization Active NPI Family Medicine Physician · Cadillac, MI

NPI 1487051611 · NPPES record last updated Sep 1, 2026

Key facts

NPI
1487051611
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MUNSON HEALTHCARE CADILLAC
Practice address
400 Hobart St
Cadillac, MI 49601-2331
Phone
(231) 876-7234
Fax
(231) 876-7176
NPI assigned
Dec 3, 2014
Organization subpart
Yes
Parent organization (as reported)
MUNSON HEALTHCARE

Authorized official

Name
Michael Frye
Title
Pres. Ambulatory & Bus. Development
Phone
(704) 458-8010

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 8

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 45

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

View all 45

Affiliated clinicians 515

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 515

Medicare Care Compare: Hospital

Listed as
Munson Healthcare Cadillac Hospital CCN 230081
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

Hospital certification: CCN 230081

Legal name
MUNSON HEALTHCARE CADILLAC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 7, 1988
Beds
117
Ownership / control type
Church
Most recent change of ownership
Feb 1, 2015 (1 total)
Organization structure
Corporation · Non-profit
Incorporated
Jun 17, 2014 in MI
Enrollment address
400 Hobart St
Cadillac, MI 49601-2331
Other Hospital Practice Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Page
Individual
Corporate Officer
Trustee
Jan 1, 2024
Ruth Hoppe
Individual
Corporate Director
Trustee
Jan 1, 2022
Paul Konopacki
Individual
Corporate Officer
Cfo
Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
Operational/Managerial Control
Cfo
Jan 1, 2024
Vincent Schultz
Individual
Corporate Officer
Trustee
Jan 1, 2024
Thomas Veryser
Individual
Corporate Director
Trustee
Jan 1, 2022
Kenneth D Bloem
Individual
Corporate Director
Trustee
Jan 1, 2022
Timothy Nelson
Individual
Corporate Director
Treasurer
Jan 1, 2022
David Menegebier
Individual
Corporate Officer
Trustee
Jan 1, 2024
Edward Lanphier
Individual
Corporate Director
Board Member
Jan 1, 2026
Kathy Dixon
Individual
Corporate Director
Trustee
Jan 1, 2022
Mary Sanders
Individual
Corporate Director
Trustee
Jan 1, 2022
Elaine Wood
Individual
Corporate Director
Trustee
Jan 1, 2022
Munson Healthcare
Organization · Traverse City, MI
Corporation
Operational/Managerial Control Feb 1, 2015 100%
Peter E Marinoff
Individual
Corporate Director Dec 13, 2023 100%
W-2 Managing Employee Jan 1, 2022
Edwin a Ness
Individual
Corporate Officer
Ceo
Jul 1, 2004
Owen Roberts
Individual
Corporate Officer
Vice Chairperson
Feb 1, 2015
Corporate Director
Trustee
Jan 1, 2022
Bruce Zenner
Individual
Corporate Director
Trustee
Jan 1, 2022
Sakura Takano
Individual
Corporate Director
Trustee
Jan 1, 2022
Kristine Thomas
Individual
Corporate Director
Trustee
Jan 1, 2022
Brian Postma
Individual
Corporate Director
Trustee
Jan 1, 2022
Dino Recchia
Individual
Corporate Officer
Trustee
Jan 1, 2024
Jennifer King
Individual
Corporate Officer
Trustee
Jan 1, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20150211000241 MI Part a Provider - Hospital 6305161514 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cadillac, MI; Traverse City, MI
O20150401000808 MI Part B Supplier - Clinic/Group Practice 6305161514 Receives reassigned benefits from 174 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frankfort, MI; Traverse City, MI; MC Bain, MI; Manistee, MI; Kalkaska, MI; Grayling, MI; Gaylord, MI; Charlevoix, MI…

National Provider Directory

Part of
Munson Manor Hospitality House

Locations

2800 W Big Beaver Rd
Ste V-368
Troy, MI 48084
Phone (248) 816-0990

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered Nurse
Group: 193200000X MULTI-SPECIALTY GROUP
163WI0500X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X MI Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X MI
Cardiovascular Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RC0000X MI
Hematology & Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RH0003X MI
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207V00000X MI
Infusion Therapy Clinic/Center 261QI0500X
Adult Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LA2200X MI
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X MI

Addresses

Primary practice location

400 Hobart St
Cadillac, MI 49601-2331

Mailing address

400 Hobart St
Cadillac, MI 49601-2331
Phone (231) 876-7234

Other practice location 1

217 S Madison St
Traverse City, MI 49684-2321
Phone (231) 392-8400

Other practice location 2

701 N Otsego Ave
Gaylord, MI 49735-1558
Phone (989) 731-7760

Other practice location 3

1465 E Parkdale Ave
Manistee, MI 49660-9709
Phone (231) 876-6421

Other names

  • Munson Healthcare Cadillac Physician Network Doing business as

Other providers in Cadillac, MI

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

Sources for this page

Verify at the official NPI Registry.