Superior Walk-in Center, PC
Organization Active NPI Family Medicine Physician · Munising, MI
NPI 1669575148 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1669575148
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301058344 (MI)
- Legal business name
- SUPERIOR WALK-IN CENTER, PC
- Practice address
- 1504 Sand Point Road
Munising, MI 49862 - Phone
- (906) 387-4220
- Fax
- (906) 387-5449
- NPI assigned
- Sep 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Kurt Richard Olson, MD.
- Title
- President
- Phone
- (906) 387-4220
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 4
Practitioners 12
-
Kurt Richard Olson, M.D.
-
Karen Sue Freeborn, FNP-BC
-
Rachel Lauren Klawitter, FNP-C
-
Jill A. Magel, P.A.
-
Angela Victoria Moore, MSN, FNP-C, PMHNP-BC
-
Mark Walter Olson, M.D.
-
Ryan Kurt Olson, CNP
-
Emily Rose Prunick, FNP-C
-
Rachel Elizabeth Teifke, NP-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D1024697 | Superior Walk in Center | Provider-performed microscopy | Jan 15, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070123000220 | MI | Part B Supplier - Clinic/Group Practice | 6204837057 |
Receives reassigned benefits from 14 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Marquette, MI; Munising, MI |
National Provider Directory
- Tax ID family
- Superior Walk-in Center PC
Locations
1504 Sandpoint Rd
Munising, MI 49862
Phone (906) 387-4220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 4301058344 | MI | Yes |
Addresses
Primary practice location
1504 Sand Point Road
Munising, MI 49862
Mailing address
1504 Sand Point Road
Munising, MI 49862
Phone (906) 387-4220
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0800217321 | Other | MI | BLUE CROSS OF MI |
| 3114604 | Medicaid | MI |
Other providers in Munising, MI
- Natalie Martine Stark
- Bridget Stoetzer
- Superior Mobile Diagnostics LLC
- Superior Mobile Sonography
- Superior Walk-in Center, PC
- Tendercare (Michigan) Inc.
- Chelsea Teal Texter
- Three Little Birds Counseling, LLC
- Elena Torongo
- Jessie Lynn Trudgeon
All providers in Munising, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.