NPIMap

Organization Active NPI

Superior Walk-in Center, PC

  • Family Medicine Physician
  • Munising, MI
National Provider Identifier
1669575148
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301058344 Issued in 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
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Kurt Richard Olson, MD.NPI 1457309569
Title
President
Phone
(906) 387-4220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 4301058344 MI Primary

Addresses

Primary practice location

1504 Sand Point Road
Munising, MI 49862

Mailing address

1504 Sand Point Road
Munising, MI 49862
Phone (906) 387-4220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1024697Superior Walk in Center1504 Sand Point Road, Munising, MI 49862Provider-performed microscopyJan 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Superior Walk-in Center PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1669575148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 SAND POINT ROAD",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "49862",
            "telephone_number": "906-387-4220",
            "fax_number": "906-387-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 SAND POINT ROAD",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "49862",
            "telephone_number": "906-387-4220",
            "fax_number": "906-387-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR WALK-IN CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-387-4220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301058344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munising, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.