NPIMap

Organization Active NPI

Mymichigan Medical Center Tawas

Doing business as Ascension St Joseph Hospital Hale Medical Clinic

  • Rural Health Clinic/Center
  • Hale, MI
National Provider Identifier
1730177528
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MYMICHIGAN MEDICAL CENTER TAWAS
Doing business as
Ascension St Joseph Hospital Hale Medical Clinic
Mymichigan Family Medicine
Practice address
3190 Northridge Rd
Hale, MI 48739-9276
Phone
(989) 728-6000
Fax
(989) 728-6003
NPI assigned
Oct 6, 2005
Last updated
Jan 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Sarah James
Title
Manager Patient Accounting
Phone
(989) 701-4734

Specialties & licenses 1

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

Addresses

Primary practice location

3190 Northridge Rd
Hale, MI 48739-9276

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (844) 832-1956

Other names 2

  • Ascension St Joseph Hospital Hale Medical Clinic Doing business as
  • MYMICHIGAN FAMILY MEDICINE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050910000280 MI Part A Provider - Rural Health Clinic 9638070766 Practice locations: Hale, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730177528. Details of each certification follow.

Rural health clinic certification: CCN 238538

Legal name
MYMICHIGAN MEDICAL CENTER TAWAS
Doing business as
MYMICHIGAN FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 20, 1996
Last certification
Nov 14, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
3190 Northridge Rd
Hale, MI 48739-9276
Related CCNs
230100

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
23D0375132Mymichigan Family Medicine3190 Northridge Drive, Hale, MI 48739Certificate of waiverSep 3, 2026

National Provider Directory

National Provider Directory
Tax ID family
Oscoda St Joseph Health11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Marcia Mastracci Ditmyer Individual Corporate OfficerBoard Member Aug 1, 2024
Bapineedu Maganti Individual Corporate OfficerBoard Member Aug 1, 2024
Mary Catherine Hannah Individual Corporate OfficerBoard Member Aug 1, 2024
Charity Higgins Individual Corporate DirectorDirector of Medical Practices Jan 1, 2017 5%
W-2 Managing EmployeeDirector of Medical Practices Jan 1, 2017
Sarah James Individual Corporate OfficerOperations Manager, Pe Oct 24, 2025
Steve Meyer Individual Corporate OfficerBoard Member Aug 1, 2024
John Freel Individual Corporate OfficerBoard Member Aug 1, 2024
Laurilee McCord Individual W-2 Managing EmployeeCredentialing Coord Jul 1, 2018
Samantha Hunter Individual W-2 Managing Employee Oct 24, 2025
Bryan R Cross Individual Corporate OfficerBoard Member Aug 1, 2024
Brodi Katelyn Lynch Individual Corporate OfficerBoard Member Aug 1, 2024
Ronald a Bays Individual Corporate OfficerBoard Member Aug 1, 2024
Heather Bauman Individual Corporate OfficerBoard Member Aug 1, 2024
Mymichigan Health Organization, Midland, MI Chain home office 5% Or Greater Direct Ownership Interest Oct 25, 2025 100%
Michael Erickson Individual Corporate OfficerBoard Member Aug 1, 2024
Mark Flegenheimer Individual Corporate OfficerBoard Member Aug 1, 2024
Andrew Bethune Individual Corporate OfficerBoard Member Aug 1, 2024
Jo S May Individual Corporate OfficerBoard Member Aug 1, 2024
Tricia Gorde Individual Corporate DirectorDirector, Provider Enrollment Oct 24, 2025
Jimmy Greene Individual Corporate OfficerBoard Member Aug 1, 2024
Mymichigan Medical Center Tawas Organization, Midland, MI Corporation Operational/Managerial Control Oct 25, 2025 100%
Terence Moore Individual Corporate OfficerBoard Member Aug 1, 2024

Owners & managing parties with NPI records 11

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

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mymichigan Medical Center TawasTawas City, MI, CCN 230100 Hospital Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Health Park OscodaOscoda, MI, CCN 233985 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Internal MedicineTawas City, MI, CCN 233986 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Obstretics & GynecologyTawas City, MI, CCN 238534 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Family MedicineAu Gres, MI, CCN 238570 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Family MedicineTawas City, MI, CCN 233991 Rural health clinic Operational/Managerial Control (100%) Oct 25, 2025
Mymichigan Beech Street BuildingTawas City, MI, CCN 238911 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 4

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": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1730177528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "844-832-1956",
            "fax_number": "989-633-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 NORTHRIDGE RD",
            "city": "HALE",
            "state": "MI",
            "postal_code": "487399276",
            "telephone_number": "989-728-6000",
            "fax_number": "989-728-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMICHIGAN MEDICAL CENTER TAWAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "MANAGER PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "989-701-4734"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension St Joseph Hospital Hale Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MYMICHIGAN FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hale, MI

Sources for this page

Verify at the official NPI Registry.