NPIMap

Organization Active NPI

Sparrow Carson Hospital

Doing business as University of Michigan Health-Sparrow

  • Rural Health Clinic/Center
  • Carson City, MI
National Provider Identifier
1699200550
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SPARROW CARSON HOSPITAL
Doing business as
University of Michigan Health-Sparrow
Practice address
639 E Main St
Carson City, MI 48811-9795
Phone
(989) 584-3107
NPI assigned
Apr 27, 2017
Last updated
Apr 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SPARROW HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Authorized official

Name
Misty Gunter Russian
Title
Supervisor, Provider Enrollment
Phone
(517) 253-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

639 E Main St
Carson City, MI 48811-9795

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (989) 584-0105

Other names 3

  • University of Michigan Health-Sparrow Doing business as
  • Sparrow Medical Group OB/GYN Carson City Other name
  • University of Michigan Health-Sparrow Carson OB/GYN Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170605000135 MI Part A Provider - Rural Health Clinic 7113836701 Practice locations: Carson City, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699200550. Details of each certification follow.

Rural health clinic certification: CCN 238706

Legal name
SPARROW CARSON HOSPITAL
Doing business as
UNIVERSITY OF MICHIGAN HEALTH-SPARROW CARSON OB/GYN
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 6, 2018
Last certification
Feb 6, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
639 E Main St
Carson City, MI 48811-9795
Related CCNs
230208

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
23D0722626University of Michigan Health Sparrow639 E Main Street, Carson City, MI 48811Provider-performed microscopyApr 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sparrow Carson Hospital20 organizations share this tax ID, including this one
Part of
Sparrow Health System

Other organizations with this tax ID 19

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

View all 19

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Matthew D Wilcox Individual Corporate OfficerBoard Member Jul 1, 2025
Eric J Strucko Individual Corporate OfficerBoard Member / Treasurer Jul 1, 2025
Laura M Gibson Individual Corporate OfficerBoard Member Jul 1, 2025
Um Health Organization, Ann Arbor, MI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2023 100%
Candace S Metcalf Individual Corporate OfficerBoard Member Jul 1, 2025
Harper T Wildern Individual Corporate OfficerBoard Member Jul 1, 2025
Margaret a Dimond Individual Corporate OfficerPresident, Um Health Regional Netwo Jan 1, 2024
W-2 Managing EmployeePresident, Um Health Regional Netwo Jan 1, 2024
Misty Gunter Russian Individual W-2 Managing EmployeeSupervisor, Provider Enrollment Jan 1, 2024
Daniel Balice Individual Corporate OfficerBoard Member Jul 1, 2025
Carol Priebe Wiles Individual Corporate OfficerBoard Member Jul 1, 2025
Sparrow Health System Organization, Lansing, MI Corporation, Non-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 23, 1996 100%
John Milewski Individual Corporate OfficerBoard Member Jul 1, 2025
Gregory a Holzhei Individual Corporate OfficerBoard Member/ Secretary Jul 1, 2025
John Hendrickson Individual Corporate OfficerBoard Member/ Vice Chair Jul 1, 2025
Bruce a Courtade Individual Corporate OfficerBoard Member Jul 1, 2025
Anthony Mazzali Individual Corporate OfficerBoard Member Jul 1, 2025
Timothy L Williams Individual Corporate OfficerBoard Member Jul 1, 2025
Lakeeya K Tucker Individual Corporate OfficerBoard Member Jul 1, 2025

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 17

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1699200550",
    "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": "989-584-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 E MAIN ST",
            "city": "CARSON CITY",
            "state": "MI",
            "postal_code": "488119795",
            "telephone_number": "989-584-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARROW CARSON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARROW HEALTH SYSTEM",
        "enumeration_date": "2017-04-27",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "RUSSIAN",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "GUNTER",
        "authorized_official_title_or_position": "SUPERVISOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "517-253-6308"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "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": "Sparrow Medical Group OB/GYN Carson City",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "University of Michigan Health-Sparrow Carson OB/GYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carson City, MI

Sources for this page

Verify at the official NPI Registry.