NPIMap

Organization Active NPI

Chippewa County Health Department

  • Student Health Clinic/Center
  • Sault Sainte Marie, MI
National Provider Identifier
1689796930
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
4301030101 Issued in MI
Legal business name
CHIPPEWA COUNTY HEALTH DEPARTMENT
Practice address
904 Marquette Ave
Room 622
Sault Sainte Marie, MI 49783-3301
Phone
(906) 632-5690
Fax
(906) 635-1325
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Authorized official

Name
Karen Marie Senkus
Title
Health Officer
Phone
(906) 253-3103

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Adolescent and Children Mental Health Clinic/Center 261QM0855X 6301008585 MI
Primary Care Clinic/Center 261QP2300X 4301030101 MI
Student Health Clinic/Center 261QS1000X 4301030101 MI Primary

Addresses

Primary practice location

904 Marquette Ave
Room 622
Sault Sainte Marie, MI 49783-3301

Mailing address

508 Ashmun St Ste 120
Sault Sainte Marie, MI 49783-1976
Phone (906) 635-1568

Other identifiers 6

IdentifierTypeStateIssuer
4905013MedicaidMI
4905004MedicaidMI
680A710440OtherMIBCBS-MENTAL HEALTH
4904983MedicaidMI
500A710530OtherMIBCBS-NP GROUP
4904992MedicaidMI

Other names 1

  • Sault High Adolescent Care Center (SHACC) Other name

National Provider Directory

National Provider Directory

Locations

904 Marquette Ave
#601
Sault Sainte Marie, MI 49783
Phone 90663538395802

904 Marquette Ave
Rm 601
Sault Sainte Marie, MI 49783

904 Marquette Ave
Ste 622
Sault Sainte Marie, MI 49783
Phone (906) 253-3103

Practitioners & affiliated clinicians

Practitioners 4

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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1689796930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 ASHMUN ST STE 120",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831976",
            "telephone_number": "906-635-1568",
            "fax_number": "906-253-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 MARQUETTE AVE",
            "address_2": "ROOM 622",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497833301",
            "telephone_number": "906-632-5690",
            "fax_number": "906-635-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIPPEWA COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "SENKUS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "906-253-3103"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MI",
            "license": "6301008585",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301030101",
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "MI",
            "license": "4301030101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4905013",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4905004",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MENTAL HEALTH",
            "identifier": "680A710440",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4904983",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-NP GROUP",
            "identifier": "500A710530",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4904992",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sault High Adolescent Care Center (SHACC)",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sault High Adolescent Care Center (SHACC)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sault Sainte Marie, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.