NPIMap

Organization Active NPI

Bay Mills Indian Community

  • Federally Qualified Health Center (FQHC)
  • Brimley, MI
National Provider Identifier
1851358873
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
OA76020 Issued in MI
Legal business name
BAY MILLS INDIAN COMMUNITY
Practice address
12455 W Lakeshore Dr
Brimley, MI 49715-9327
Phone
(906) 248-5527
Fax
(906) 248-5765
NPI assigned
Apr 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Authorized official

Name
Abby Kaunisto
Title
Clinic Coordinator
Phone
(906) 248-8315

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X OA76020 MI Primary

Addresses

Primary practice location

12455 W Lakeshore Dr
Brimley, MI 49715-9327

Mailing address

12455 W Lakeshore Dr
Brimley, MI 49715-9327
Phone (906) 248-5527

Other names 1

  • Bay Mills Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bay Mills Health Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1851358873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12455 W LAKESHORE DR",
            "city": "BRIMLEY",
            "state": "MI",
            "postal_code": "497159327",
            "telephone_number": "906-248-5527",
            "fax_number": "906-248-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12455 W LAKESHORE DR",
            "city": "BRIMLEY",
            "state": "MI",
            "postal_code": "497159327",
            "telephone_number": "906-248-5527",
            "fax_number": "906-248-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY MILLS INDIAN COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "KAUNISTO",
        "authorized_official_first_name": "ABBY",
        "authorized_official_title_or_position": "CLINIC COORDINATOR",
        "authorized_official_telephone_number": "906-248-8315"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MI",
            "license": "OA76020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Mills Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brimley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.