NPIMap

Organization Active NPI

Newaygo County General Hospital Association

  • Emergency Medicine Physician
  • Fremont, MI
National Provider Identifier
1629070982
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101044973 Issued in MI
Legal business name
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Practice address
212 S Sullivan Ave
Fremont, MI 49412-1548
Phone
(231) 924-3300
NPI assigned
Jun 1, 2005
Last updated
Feb 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Authorized official

Name
John M Sella
Title
Vice President Finance, Cfo
Phone
(231) 924-1347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101044973 MI Primary

Addresses

Primary practice location

212 S Sullivan Ave
Fremont, MI 49412-1548

Mailing address

212 S Sullivan
Fremont, MI 49412
Phone (231) 924-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423001232 MI Part B Supplier - Clinic/Group Practice 4880503051 Receives reassigned benefits from 205 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fremont, MI; Newaygo, MI; Hesperia, MI

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

231 W Pine Lake Dr
Newaygo, MI 49337
Phone (231) 652-4618

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1629070982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S SULLIVAN",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "49412",
            "telephone_number": "231-924-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S SULLIVAN AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121548",
            "telephone_number": "231-924-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "SELLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE, CFO",
        "authorized_official_telephone_number": "231-924-1347"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101044973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.