NPIMap

Organization Active NPI

Mymichigan Medical Center Sault

Doing business as MyMichigan Primary Care

  • Rural Health Clinic/Center
  • Sault Sainte Marie, MI
National Provider Identifier
1487164240
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MYMICHIGAN MEDICAL CENTER SAULT
Doing business as
MyMichigan Primary Care
Practice address
550 Osborn Blvd
Sault Sainte Marie, MI 49783-1899
Phone
(906) 253-2665
NPI assigned
Oct 6, 2017
Last updated
Feb 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Authorized official

Name
Sarah James
Title
Manager, Provider Enrollment
Phone
(989) 701-4734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

550 Osborn Blvd
Sault Sainte Marie, MI 49783-1899

Mailing address

4000 Wellness Dr
Midland, MI 48670-0001
Phone (844) 832-1956

Other names 2

  • MyMichigan Primary Care Doing business as
  • WMH Primary Care Sault Ste Marie Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200701000581 MI Part A Provider - Rural Health Clinic 7315936481 Practice locations: Sault Sainte Marie, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487164240. Details of each certification follow.

Rural health clinic certification: CCN 238768

Legal name
MYMICHIGAN MEDICAL CENTER SAULT
Doing business as
MYMICHIGAN PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 29, 2021
Last certification
Mar 29, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
550 Osborn Blvd
Sault Sainte Marie, MI 49783-1899
Related CCNs
230239

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

Other NPIs with the same Medicare PAC ID 12

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2116637Mymichigan Primary Care - C M C550 Osborn Blvd Suite 1006, Sault Sainte Marie, MI 49783Certificate of waiverJul 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
War Memorial Hospital C32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Samantha Hunter Individual W-2 Managing Employee Feb 19, 2025
Tina Church Individual Corporate Director Aug 15, 2024
Tricia Gorde Individual Corporate DirectorDirector, Provider Enrollment Jan 20, 2025

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mymichigan Primary Care DrummondDrummond Island, MI, CCN 238767 Rural health clinic Operational/Managerial Control (100%) Aug 24, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772150400000",
    "number": "1487164240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486700001",
            "telephone_number": "844-832-1956",
            "fax_number": "989-633-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 OSBORN BLVD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831899",
            "telephone_number": "906-253-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMICHIGAN MEDICAL CENTER SAULT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-06",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "MANAGER, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "989-701-4734"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyMichigan Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WMH Primary Care Sault Ste Marie",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sault Sainte Marie, MI

Sources for this page

Verify at the official NPI Registry.