NPIMap

Organization Active NPI

Schoolcraft Memorial Hospital

Doing business as Schoolcraft Memorial Hospital Rural Health Clinic

  • Rural Health Clinic/Center
  • Manistique, MI
National Provider Identifier
1629079389
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SCHOOLCRAFT MEMORIAL HOSPITAL
Doing business as
Schoolcraft Memorial Hospital Rural Health Clinic
Practice address
7870W US Highway 2
Manistique, MI 49854-8992
Phone
(906) 341-2153
Fax
(906) 341-3299
NPI assigned
Aug 3, 2005
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SCHOOLCRAFT MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Andy Bertapelle
Title
Ceo
Phone
(906) 341-3221

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

7870W US Highway 2
Manistique, MI 49854-8992

Mailing address

7870W US Highway 2
Manistique, MI 49854-8992
Phone (906) 341-2153

Other identifiers 1

IdentifierTypeStateIssuer
0G71004OtherMIRHC BCBS

Other names 1

  • Schoolcraft Memorial Hospital Rural Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209001182 MI Part A Provider - Rural Health Clinic 4082525118 Practice locations: Manistique, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629079389. Details of each certification follow.

Rural health clinic certification: CCN 238588

Legal name
SCHOOLCRAFT MEMORIAL HOSPITAL
Doing business as
SCHOOLCRAFT MEMORIAL HOSPITAL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 23, 2004
Last certification
Mar 26, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1990 in MI
Enrollment address
7870W US Highway 2
Manistique, MI 49854-8992
Related CCNs
231303

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Nathan B Eliason MD

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
James Blanchard Individual Corporate DirectorBoard Member Jan 1, 2019
Kevin Knaffla Individual Corporate Director Aug 13, 2020
Andrew Joseph Bertapelle Individual Corporate OfficerCeo Aug 31, 2022
W-2 Managing Employee Aug 31, 2022
Operational/Managerial Control Aug 31, 2022
Eric J Price Individual Corporate OfficerCfo Jan 2, 2023
W-2 Managing Employee Jan 2, 2023
Operational/Managerial Control Jan 2, 2023
Cindy Olli Individual Corporate DirectorBoard Member Jun 25, 2020
Lisa Lee Desjarden Individual W-2 Managing EmployeeBusiness Office Supervisor Feb 12, 2016 100%
Howard Parmentier Individual Corporate DirectorBoard Member Jun 24, 2021
Peter J Hood Individual Corporate Director Mar 31, 2018
Ryan Fausett Individual Corporate DirectorBoard Member Oct 28, 2021

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1629079389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7870W US HIGHWAY 2",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498548992",
            "telephone_number": "906-341-2153",
            "fax_number": "906-341-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7870W US HIGHWAY 2",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498548992",
            "telephone_number": "906-341-2153",
            "fax_number": "906-341-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHOOLCRAFT MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCHOOLCRAFT MEMORIAL HOSPITAL",
        "enumeration_date": "2005-08-03",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "BERTAPELLE",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "906-341-3221"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC BCBS",
            "identifier": "0G71004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Schoolcraft Memorial Hospital Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manistique, MI

Sources for this page

Verify at the official NPI Registry.