NPIMap

Organization Active NPI

Sparrow Carson Hospital

  • Urology Physician
  • Carson City, MI
National Provider Identifier
1689407223
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SPARROW CARSON HOSPITAL
Practice address
245 S 2ND St Ste 110
Carson City, MI 48811-9650
Phone
(517) 364-5655
Fax
(517) 364-5654
NPI assigned
Aug 20, 2024
Organization subpart
Yes
Parent organization
SPARROW HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Misty Gunter Russian
Title
Regional Manager, Provider Enrollme
Phone
(517) 253-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

245 S 2ND St Ste 110
Carson City, MI 48811-9650

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (517) 364-7999

Other practice location 1

406 E Elm St
Carson City, MI 48811-9693
Phone (517) 364-5655

Other names 2

  • University of Michigan Health-Sparrow Doing business as
  • University of Michigan Health-Sparrow Carson City Urology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000046 MI Part B Supplier - Clinic/Group Practice 7113836701 Receives reassigned benefits from 241 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, MI; Stanton, MI; Mount Pleasant, MI; Ithaca, MI; Fowler, MI; Carson City, MI

Other NPIs on the same Medicare enrollment 19

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

View all 19

National Provider Directory

National Provider Directory
Part of
Sparrow Health System

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1689407223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860081",
            "telephone_number": "517-364-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S 2ND ST STE 110",
            "city": "CARSON CITY",
            "state": "MI",
            "postal_code": "488119650",
            "telephone_number": "517-364-5655",
            "fax_number": "517-364-5654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 E Elm St",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "MI",
            "postal_code": "488119693",
            "country_code": "US",
            "telephone_number": "517-364-5655",
            "fax_number": "517-364-5654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPARROW CARSON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARROW HEALTH SYSTEM",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "RUSSIAN",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "GUNTER",
        "authorized_official_title_or_position": "REGIONAL MANAGER, PROVIDER ENROLLME",
        "authorized_official_telephone_number": "517-253-6308"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Michigan Health-Sparrow",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University of Michigan Health-Sparrow Carson City Urology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carson City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.