NPIMap

Organization Active NPI

Munson Healthcare Charlevoix Hospital

  • Urology Physician
  • Charlevoix, MI
National Provider Identifier
1609477488
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Practice address
11695 Park Ave
Suite a
Charlevoix, MI 49720
Phone
(231) 487-2270
Fax
(231) 487-6168
NPI assigned
Nov 6, 2020
Organization subpart
Yes
Parent organization
MUNSON HEALTHCARE CHARLEVOIX HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

11695 Park Ave
Suite a
Charlevoix, MI 49720

Mailing address

11695 Park Ave
Suite a
Charlevoix, MI 49720
Phone (231) 487-2270

Other practice location 1

405 N Division Rd Ste 2
Petoskey, MI 49770-9046
Phone (231) 487-2270

Other names 1

  • Munson Healthcare Charlevoix Urology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071011000237 MI Part B Supplier - Clinic/Group Practice 4284528035 Receives reassigned benefits from 34 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Traverse City, MI; Petoskey, MI; Charlevoix, MI; Manistee, MI; Kalkaska, MI; Harbor Springs, MI; Grayling, MI; Gaylord, MI…

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Charlevoix Area Hosp13 organizations share this tax ID, including this one
Part of
Charlevoix Area Hosp

Other organizations with this tax ID 12

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": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1609477488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11695 PARK AVE",
            "address_2": "SUITE A",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "49720",
            "telephone_number": "231-487-2270",
            "fax_number": "231-487-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11695 PARK AVE",
            "address_2": "SUITE A",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "49720",
            "telephone_number": "231-487-2270",
            "fax_number": "231-487-6168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 N Division Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497709046",
            "country_code": "US",
            "telephone_number": "231-487-2270",
            "fax_number": "231-487-6168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE CHARLEVOIX HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUNSON HEALTHCARE CHARLEVOIX HOSPITAL",
        "enumeration_date": "2020-11-06",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "FRYE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRES. AMBULATORY & BUS. DEVELOPMENT",
        "authorized_official_telephone_number": "704-458-8010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munson Healthcare Charlevoix Urology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Munson Healthcare Charlevoix Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlevoix, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.