Central Michigan University

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

CENTRAL MICHIGAN UNIVERSITY

Practice address

2981 Health Pkwy
Suite B
Mount Pleasant, MI 48858-9347

Phone

(989) 772-6880

Fax

(989) 772-6817

NPI assigned

Feb 14, 2012

Last updated

Oct 22, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kelly J Gronda

Title

Provider Enrollment Specialist

Phone

(989) 774-3334

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 7

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

• Central Michigan University

  • Clinical Psychologist
  • Mt Pleasant, MI
  • NPI 1073987616

  O20040416000029

  Same enrollment
• Central Michigan University

  • Behavior Analyst
  • Mt Pleasant, MI
  • NPI 1285043760

  O20040416000029

  Same enrollment
• Central Michigan University

  • Sports Medicine (Family Medicine) Physician
  • Mt Pleasant, MI
  • NPI 1447606801

  O20040416000029

  Same enrollment
• Central Michigan University

  • Family Medicine Physician
  • Mt Pleasant, MI
  • NPI 1487686754

  O20040416000029

  Same enrollment
• Central Michigan University

  • Internal Medicine Physician
  • Mt Pleasant, MI
  • NPI 1558709493

  O20040416000029

  Same enrollment
• Central Michigan University

  dba Central Michigan Universiy

  • Audiologist
  • Mt Pleasant, MI
  • NPI 1619062817

  O20040416000029

  Same enrollment
• Central Michigan University

  • Pediatrics Physician
  • Mt Pleasant, MI
  • NPI 1659711760

  O20040416000029

  Same enrollment

Locations

Practitioners 1

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.

• Cara Lee Crawford-Bartle, MD

  • Family Medicine Physician
  • Marquette, MI
  • NPI 1982139382
  NPD (past)

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1790058386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2981 HEALTH PKWY",
            "address_2": "SUITE B",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488589347",
            "telephone_number": "989-772-6880",
            "fax_number": "989-772-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2981 HEALTH PKWY",
            "address_2": "SUITE B",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488589347",
            "telephone_number": "989-772-6880",
            "fax_number": "989-772-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MICHIGAN UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "GRONDA",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "989-774-3334",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4337963",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Michigan University
• Central Michigan University
• Central Michigan University (Central Michigan Universiy)
• Central Michigan University
• Central Michigan University
• Central Michigan Urgent Care
• Central Michigan Urology Center PC
• Central Rehabilitation Services, Inc.
• Central View Counseling PLLC
• Vanessa Cervera

• Surgery Physician in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.