NPIMap

Organization Active NPI

Central Michigan University

  • Family Medicine Physician
  • Mt Pleasant, MI
National Provider Identifier
1487686754
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTRAL MICHIGAN UNIVERSITY
Practice address
202 Foust Hall
Central Michigan University Health Services
Mt Pleasant, MI 48859-0001
Phone
(989) 774-1748
Fax
(989) 774-4335
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Mrs. Amber Stites
Title
Health Info Specialist
Phone
(989) 774-6599

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MI Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

202 Foust Hall
Central Michigan University Health Services
Mt Pleasant, MI 48859-0001

Mailing address

202 Foust HL
Central Michigan University Health Services
Mt Pleasant, MI 48859-0001
Phone (989) 774-6599

Other identifiers 1

IdentifierTypeStateIssuer
0C76005OtherMIBCBS NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416000029 MI Part B Supplier - Clinic/Group Practice 3577558907 Receives reassigned benefits from 21 practitioners
7 other NPIs on this enrollment
Practice locations: Alma, MI; Mt Pleasant, MI

National Provider Directory

National Provider Directory

Locations

1101 Health Professions
Mount Pleasant, MI 48859
Phone (989) 774-2597

Mount Pleasant, MI 48859

600 E Preston St
#200
Mount Pleasant, MI 48859

128 E Campus Dr
Mt Pleasant, MI 48859

1280 E Campus Dr
Ste 2104
Mt Pleasant, MI 48859
Phone (989) 774-6599

Ownership & related parties

Other NPIs on the same Medicare enrollment 7

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

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1487686754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 FOUST HL",
            "address_2": "CENTRAL MICHIGAN UNIVERSITY HEALTH SERVICES",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488590001",
            "telephone_number": "989-774-6599",
            "fax_number": "989-774-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 FOUST HALL",
            "address_2": "CENTRAL MICHIGAN UNIVERSITY HEALTH SERVICES",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488590001",
            "telephone_number": "989-774-1748",
            "fax_number": "989-774-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MICHIGAN UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "STITES",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "HEALTH INFO SPECIALIST",
        "authorized_official_telephone_number": "989-774-6599",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "0C76005",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.