Edward W. Sparrow Hospital Association
Organization Active NPI Family Medicine Physician · Dewitt, MI
NPI 1821041013 · NPPES record last updated Mar 26, 2024
Key facts
- NPI
- 1821041013
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- EDWARD W. SPARROW HOSPITAL ASSOCIATION
- Practice address
- 13191 Schavey Rd
Suite 3
Dewitt, MI 48820-9036 - Phone
- (517) 669-9109
- Fax
- (517) 669-9839
- NPI assigned
- May 18, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARROW HEALTH SYSTEM
Authorized official
- Name
- Misty Gunter Russian
- Title
- Supervisor, Provider Enrollment
- Phone
- (517) 253-6308
Other NPIs on the same Medicare enrollment 34
Practitioners 13
-
Jaibir Bhullar, MD
-
Amanda Borbonus, LMSW
-
Beinaz Menagi, MD
-
Anna Margaret O'Rourke, LMSW, CAADC
-
Shelby Reitzel, MD
-
Travis Jon Short, DO
-
Lei Sun, DO
-
Aimee Marie Tegtmeier, D.O.
-
Jonathan Chan, MD
-
Jake T Moore, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040102000790 | MI | Part B Supplier - Clinic/Group Practice | 6709799166 |
Receives reassigned benefits from 965 practitioners 41 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lansing, MI; Mason, MI; Okemos, MI; Owosso, MI; Saint Johns, MI; Williamston, MI; Carson City, MI; Charlotte, MI… |
National Provider Directory
- Part of
- Sparrow Health System
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
13191 Schavey Rd
Suite 3
Dewitt, MI 48820-9036
Mailing address
8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (517) 669-9109
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080A910070 | Other | MI | BCBS GROUP NUMBER |
Other names
- Sparrow Medical Group DeWitt
- University of Michigan Health-Sparrow DeWitt Primary Care
- University of Michigan Health-Sparrow Primary Care
Other providers in Dewitt, MI
- Downtown Dewitt Chiropractic, P.C.
- Thomas John Doyle
- Julia Drake
- Jackie Drushel-Vanamburg
- Larson Pax Drzewicki
- David Joseph Fedewa
- Mary Margaret Fedewa
- Jana Marie Fisher
- Emily Anne Fritz
- Jaren Marie Pickens Gebhard
All providers in Dewitt, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.