Township of Green Lake Grand Traverse County

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

281005 Issued in MI

Legal business name

TOWNSHIP OF GREEN LAKE GRAND TRAVERSE COUNTY

Practice address

9394 10TH St
Interlochen, MI 49643

Phone

(231) 276-6297

Fax

(231) 276-9388

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Stinson

Title

Fire Captain

Phone

(231) 276-6297

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Township of Green Lake Former legal business name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1669524948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 747",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900747",
            "telephone_number": "800-244-2345",
            "fax_number": "800-329-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9394 10TH ST",
            "city": "INTERLOCHEN",
            "state": "MI",
            "postal_code": "49643",
            "telephone_number": "231-276-6297",
            "fax_number": "231-276-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWNSHIP OF GREEN LAKE GRAND TRAVERSE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "STINSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "FIRE CAPTAIN",
        "authorized_official_telephone_number": "231-276-6297",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "MI",
            "license": "281005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0B80013",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "26364",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3295644",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Township of Green Lake",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jessica Rosa
• Lorraine Shearer, NBC-HWC
• Judith Michele Strait, PSY.D., L.P.
• Strive Physical Therapy and Performance LLC
• Thompson Pharmacy, Inc.
• Trevor Kay DDS PLLC
• Linda Jane Wade
• Barbara Wilson, RD
• Michael Ross Wittig

• Land Ambulance in Interlochen, MI
• Providers in Interlochen, MI by specialty
• Land Ambulance in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.