NPIMap

Organization Active NPI

Sparrow Eaton Hospital

Doing business as University of Michigan Health-Sparrow Eaton Anesthesia

  • Anesthesiology Physician
  • Charlotte, MI
National Provider Identifier
1548439110
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
230020 Issued in MI
Legal business name
SPARROW EATON HOSPITAL
Doing business as
Sparrow Eaton Hospital
University of Michigan Health-Sparrow Eaton Anesthesia
Practice address
123 Lansing St Ste 2
Charlotte, MI 48813-1696
Phone
(517) 541-5954
Fax
(517) 541-5944
NPI assigned
Feb 27, 2008
Last updated
Mar 18, 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 18, 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, Provider Enrollment
Phone
(517) 253-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 230020 MI Primary

Addresses

Primary practice location

123 Lansing St Ste 2
Charlotte, MI 48813-1696

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (517) 253-6320

Other practice location 1

321 E Harris St
Charlotte, MI 48813-1629
Phone (517) 541-5927

Other identifiers 1

IdentifierTypeStateIssuer
0B36008OtherMIBCN ANES GROUP NUMBER

Other names 3

  • Sparrow Eaton Hospital Doing business as
  • UNIVERSITY OF MICHIGAN HEALTH-SPARROW EATON ANESTHESIA Doing business as
  • HAYES GREEN BEACH ANESTHSIA GROUP Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040213000368 MI Part B Supplier - Clinic/Group Practice 0042103509 Receives reassigned benefits from 152 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lansing, MI; Charlotte, MI; Olivet, MI; Grand Ledge, MI; Eaton Rapids, MI; East Lansing, MI

Other NPIs on the same Medicare enrollment 9

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

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
23D0375327University of Michigan Health -123 Lansing Street Suite 3, Charlotte, MI 48813Certificate of waiverJun 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Hayes Green Beach Hospi15 organizations share this tax ID, including this one
Part of
Sparrow Health System

Other organizations with this tax ID 14

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

View all 14

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1548439110",
    "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": "517-253-6320",
            "fax_number": "517-253-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 LANSING ST STE 2",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131696",
            "telephone_number": "517-541-5954",
            "fax_number": "517-541-5944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 E Harris St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "MI",
            "postal_code": "488131629",
            "country_code": "US",
            "telephone_number": "517-541-5927",
            "fax_number": "517-543-0875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPARROW EATON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARROW HEALTH SYSTEM",
        "enumeration_date": "2008-02-27",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "RUSSIAN",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "GUNTER",
        "authorized_official_title_or_position": "SUPERVISOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "517-253-6308"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "230020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN ANES GROUP NUMBER",
            "identifier": "0B36008",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sparrow Eaton Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sparrow Eaton Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UNIVERSITY OF MICHIGAN HEALTH-SPARROW EATON ANESTHESIA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HAYES GREEN BEACH ANESTHSIA GROUP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Charlotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.