NPIMap

Organization Active NPI

Sparrow Carson Hospital

Doing business as University of Michigan Health-Sparrow

  • Rural Health Clinic/Center
  • Stanton, MI
National Provider Identifier
1821068479
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
545 N State St
Stanton, MI 48888
Phone
(989) 831-8301
Fax
(989) 831-4306
NPI assigned
Jan 25, 2006
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

545 N State St
Stanton, MI 48888

Mailing address

8175 Reliable Pkwy
Chicago, IL 60686-0081
Phone (989) 584-3131

Other names 3

  • University of Michigan Health-Sparrow Doing business as
  • Sparrow Medical Group Stanton Other name
  • University of Michigan Health-Sparrow Stanton Primary Care Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040126000046 MI Part B Supplier - Clinic/Group Practice 7113836701 Receives reassigned benefits from 241 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greenville, MI; Stanton, MI; Mount Pleasant, MI; Ithaca, MI; Fowler, MI; Carson City, MI
O20080520000254 MI Part A Provider - Rural Health Clinic 7113836701 Practice locations: Stanton, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821068479. Details of each certification follow.

Rural health clinic certification: CCN 238574

Legal name
SPARROW CARSON HOSPITAL
Doing business as
UNIVERSITY OF MICHIGAN HEALTH-SPARROW
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 7, 2000
Last certification
Oct 20, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 5, 1938 in MI
Enrollment address
545 N State St
Stanton, MI 48888-9331
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).

Other NPIs on the same Medicare enrollment 19

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

View all 19

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
23D0376154University of Michigan Health - Sparrow545 N State Street P O Box 638, Stanton, MI 48888Certificate of waiverDec 17, 2027
23D2166084University of Michigan Health Sparrow545 North State Street, Stanton, MI 48888Certificate of waiverMay 12, 2027

National Provider Directory

National Provider Directory
Part of
Sparrow Health System

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Mark D Brisboe Individual Corporate Officer Jul 1, 2020
Corporate Director Jul 1, 2020
W-2 Managing Employee Jul 1, 2020
Operational/Managerial Control Jul 1, 2020
Um Health Organization, Ann Arbor, MI Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2023 100%
Regents of the University of Michigan Organization, Ann Arbor, MI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2023 100%
Thomas Ostrander Individual Corporate Officer May 27, 2009
Margaret a Dimond Individual Corporate DirectorPresident/Ceo Apr 1, 2024
W-2 Managing EmployeePresident/Ceo Apr 1, 2024
Misty Gunter Russian Individual W-2 Managing EmployeeSupervisor, Provider Enrollment Apr 1, 2024
Sparrow Health System Organization, Lansing, MI Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2015 100%

Facilities with the same owner 19

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

View all 19

Practitioners & affiliated clinicians

Practitioners 10

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": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1821068479",
    "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": "989-584-3131",
            "fax_number": "989-584-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N STATE ST",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "48888",
            "telephone_number": "989-831-8301",
            "fax_number": "989-831-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARROW CARSON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARROW HEALTH SYSTEM",
        "enumeration_date": "2006-01-25",
        "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 Stanton",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "University of Michigan Health-Sparrow Stanton Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stanton, MI

Sources for this page

Verify at the official NPI Registry.