Great Lakes Bay Health Centers

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GREAT LAKES BAY HEALTH CENTERS

Doing business as

Great Lakes Bay Health Centers Integrated Care Midland

Practice address

218 Fast Ice Dr
Midland, MI 48642-6167

Phone

(989) 921-6353

NPI assigned

Aug 26, 2024

Last updated

Aug 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawn M Christian

Title

Provider Enrollment

Phone

(989) 759-6464

Specialties & licenses 1

Addresses

Other names 1

• Great Lakes Bay Health Centers Integrated Care Midland Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609609536. Details of each certification follow.

• CCN C71031 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN C71031

Legal name

GREAT LAKES BAY HEALTH CENTERS

Doing business as

GREAT LAKES BAY HEALTH CENTERS INTEGRATED CARE MIDLAND

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Sep 6, 2024

Last certification

Sep 6, 2024

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

218 Fast Ice Dr
Midland, MI 48642-6167

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

CLIA laboratory certificates

Tax ID family

Great Lakes Bay Health Centers67 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Great Lakes Bay Health Centers

  dba Great Lakes Bay Health Centers Thumb Area

  • Federally Qualified Health Center (FQHC)
  • Bad Axe, MI
  • NPI 1386066959
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1386290153
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1386887800
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1427176502
  NPD tax ID
• Great Lakes Bay Health Centers

  dba Great Lakes Bay Health Centers Bayside Dental

  • Federally Qualified Health Center (FQHC)
  • Bay City, MI
  • NPI 1437489911
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Bay City, MI
  • NPI 1447804604
  NPD tax ID
• Great Lakes Bay Health Centers

  dba WolverineVassarHouseDental

  • Federally Qualified Health Center (FQHC)
  • Vassar, MI
  • NPI 1518299692
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1528435526
  NPD tax ID
• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1538095419
  NPD tax ID
• Great Lakes Bay Health Centers

  dba Great Lakes Bay Health Centers Saginaw United High School

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1538287313
  NPD tax ID
• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1558620237
  NPD tax ID
• Great Lakes Bay Health Centers

  dba Great Lakes Bay Health Centers Mobile Medical 2

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1598398224
  NPD tax ID

Locations

All disclosed owners & managing parties 19

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

Owners & managing parties with NPI records 2

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

• Brenda Marie Coughlin, MD

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1609864495

  W-2 Managing Employee

  CMS ownership
• John Arthur Martin, PA

  • Physician Assistant
  • Bay City, MI
  • NPI 1386632164

  Corporate Director

  CMS ownership

Practitioners 264

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.

• Macksood Ahmad Aftab, D.O.

  • Neuroradiology Physician
  • Saginaw, MI
  • NPI 1124243282
  NPD
• Deyaaeddin Ali Alnaas

  • General Practice Dentistry
  • Bridgeport, MI
  • NPI 1336642636
  NPD
• Christina Margarita Andreozzi, M.D.

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1477905230
  NPD
• Christopher Michael Archangeli, M.D.

  • Psychiatry Physician
  • Traverse City, MI
  • NPI 1972948602
  NPD
• Gerald Augustin, NP

  • Nurse Practitioner
  • Saginaw, MI
  • NPI 1356231393
  NPD
• Ayesha Baig, LMSW

  • Clinical Social Worker
  • Saginaw, MI
  • NPI 1275922718
  NPD
• Abishek Bala

  • Child & Adolescent Psychiatry Physician
  • Saginaw, MI
  • NPI 1942722426
  NPD
• Shauna Lee Barbeau, MSN CNP

  • Nurse Practitioner
  • Saginaw, MI
  • NPI 1053470963
  NPD
• Urooj Beenish, M.D

  • Family Medicine Physician
  • Owosso, MI
  • NPI 1578050563
  NPD
• Alexander Bejna, DO

  • Psychiatry Physician
  • Saginaw, MI
  • NPI 1669962320
  NPD
• Lora Benjamin, PA-C

  • Physician Assistant
  • Owosso, MI
  • NPI 1477159200
  NPD
• Rachel Bering, OD

  • Optometrist
  • Warren, MI
  • NPI 1043836661
  NPD

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1609609536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071203",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 FAST ICE DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426167",
            "telephone_number": "989-921-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES BAY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "989-759-6464"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Bay Health Centers Integrated Care Midland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gage Michael Graskey
• Allison Rose Gray
• Alycia Gray
• Jenna Gray, PT, DPT
• George H Grazul, CRNA
• Great Lakes Bay Hearing LLC
• Great Lakes Bay Orthodontics, PLC
• Great Lakes Health, LLC
• Great Lakes Home Care Unlimited LLC
• Great Lakes Home Care Unlimited LLC

• Federally Qualified Health Center (FQHC) in Midland, MI
• Providers in Midland, MI by specialty
• Federally Qualified Health Center (FQHC) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.