Mid-Michigan District Health Department

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

MID-MICHIGAN DISTRICT HEALTH DEPARTMENT

Practice address

615 N State St
Ste. 1
Stanton, MI 48888-9702

Phone

(989) 831-5237

Fax

(989) 831-3666

NPI assigned

Sep 13, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Liz Mari (John) Braddock, RS MS

Title

Health Officer

Phone

(989) 831-3640

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Mid-Michigan District Health Department

  • Public Health & General Preventive Medicine Physician
  • Stanton, MI
  • NPI 1851767370

  O20160425001828

  Same enrollment

Tax ID family

Mid Michigan District Health Department3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Mid-Michigan District Health Department

  • Public Health Dentistry
  • Stanton, MI
  • NPI 1376859173
  NPD tax ID
• Mid-Michigan District Health Department

  • Public Health & General Preventive Medicine Physician
  • Stanton, MI
  • NPI 1851767370
  NPD tax ID

Locations

Practitioners 4

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

• Jenniffer Marie Efaw, N.P.

  • Nurse Practitioner
  • Stanton, MI
  • NPI 1316247935

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Jennifer E Morse, MD

  • Family Medicine Physician
  • Mt Pleasant, MI
  • NPI 1801805536
  Medicare reassignment Care Compare group NPD
• Angela C Felton, CHW

  • Case Manager/Care Coordinator
  • Saint Johns, MI
  • NPI 1689444614
  NPD (past)
• Shelley L Treynor, RDH

  • Dental Hygienist
  • Stanton, MI
  • NPI 1366819096
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1851386106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N STATE ST",
            "address_2": "STE. 2",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889702",
            "telephone_number": "989-831-5237",
            "fax_number": "989-831-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N STATE ST",
            "address_2": "STE. 1",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889702",
            "telephone_number": "989-831-5237",
            "fax_number": "989-831-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MICHIGAN DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "BRADDOCK",
        "authorized_official_first_name": "LIZ",
        "authorized_official_middle_name": "MARI (JOHN)",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "989-831-3640",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RS MS"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100715",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY/GROUP PROVIDER ID",
            "identifier": "1464384",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth McGinn, CPSS
• Rebecca Ruth Mead
• Jaiden S Meyer
• Mid Michigan Dental Implant Center, PC
• Mid-Michigan District Health Department
• Mid-Michigan District Health Department
• Jill Marie Miller, RN
• Phillip Millerov
• Morghan Minnick, MS, BCBA
• Montcalm Area Intermediate School District

• Public Health & General Preventive Medicine Physician in Stanton, MI
• Providers in Stanton, MI by specialty
• Public Health & General Preventive Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.