Munson Healthcare Manistee Hospital
Organization Active NPI Rural Health Clinic/Center · Manistee, MI
NPI 1851753032 · NPPES record last updated Apr 20, 2026
Key facts
- NPI
- 1851753032
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- MUNSON HEALTHCARE MANISTEE HOSPITAL
- Practice address
- 1293 E Parkdale Ave
Manistee, MI 49660-8904 - Phone
- (231) 398-1840
- Fax
- (231) 398-1835
- NPI assigned
- Mar 25, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- MUNSON HEALTHCARE
Authorized official
- Name
- Michael Frye, MD
- Title
- Pres. Ambulatory & Bus. Development
- Phone
- (704) 458-8010
Owners & managing parties with NPI records 1
-
Dino Recchia, M.D.
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 2
Member organizations 2
Related certifications (CCN) 1
Facilities with the same owner 24
Practitioners 31
-
Cassandra A. Guenthardt, NP-C
-
William Henry Bell III, D.O.
-
Laura Ann Christopher, NURSE PRACTITIONER
-
Mark Salvatore Dangelo, D.O.
-
Jessica Jean Duncan, PA-C
-
Elizabeth Foster, NP
-
Marian Fuller, MD
-
Laris Edgar Galejs, M.D.
-
Sherry L Joanette, NP-C
-
Frederick Jason Kaspriak, PA-C
-
Carol D King, MD
-
Andrew Charles Luea, D.O.
-
Abdul M Malik, M.D.
-
Hugh S McLeod IV, APA-C
-
Desiree Lynn Miller, RN FNP-BC
-
Tracy Robinson, NP
-
Rachel Anne Vandenbrink, D.O.
-
Kristin J Watson, P.A.
-
William Weiner, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Rural health clinic certification: CCN 238693
- Legal name
- MUNSON HEALTHCARE MANISTEE HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Aug 31, 2016
- Last certification
- Aug 31, 2016
- Ownership / control type
- Non-profit – church related
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 1293 E Parkdale Ave
Manistee, MI 49660-8904 - Related CCNs
- 230303
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Andrew Page |
Corporate Officer |
Jan 1, 2024 | |
| Ruth Hoppe |
Corporate Director | Jan 1, 2022 | |
| Paul Konopacki |
Corporate Officer |
Jan 1, 2024 | |
| W-2 Managing Employee |
Jan 1, 2024 | ||
| Operational/Managerial Control |
Jan 1, 2024 | ||
| Thomas Veryser |
Corporate Director | Jan 1, 2022 | |
| Kenneth D Bloem |
Corporate Director | Jan 1, 2022 | |
| Timothy Nelson |
Corporate Director | Jan 1, 2022 | |
| David Menegebier |
Corporate Officer |
Jan 1, 2024 | |
| Edward Lanphier |
Corporate Officer |
Jan 1, 2026 | |
| Kathy Dixon |
Corporate Director | Jan 1, 2022 | |
| Mary Sanders |
Corporate Director | Jan 1, 2022 | |
| Elaine Wood |
Corporate Director | Jan 1, 2022 | |
| Claudia Rowland |
Corporate Officer |
Jan 1, 2026 | |
| Munson Healthcare |
Operational/Managerial Control | Apr 1, 2017 | |
| Peter E Marinoff |
Corporate Director |
Jan 23, 2024 | 100% |
| W-2 Managing Employee |
Jan 23, 2024 | 100% | |
| Edwin a Ness |
Corporate Director | Jul 1, 2004 | |
| Owen Roberts |
Corporate Director | Jan 1, 2022 | |
| Bruce Zenner |
Corporate Director | Jan 1, 2022 | |
| Sakura Takano |
Corporate Director | Jan 1, 2022 | |
| Kristine Thomas |
Corporate Director | Jan 1, 2022 | |
| Brian Postma |
Corporate Director | Apr 1, 2017 | |
| Dino Recchia |
Corporate Officer |
Jan 1, 2024 | |
| Jennifer King |
Corporate Officer |
Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040119000647 | MI | Part B Supplier - Clinic/Group Practice | 3072414333 |
Receives reassigned benefits from 68 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Manistee, MI; Frankfort, MI; Cadillac, MI |
| O20160408000981 | MI | Part a Provider - Rural Health Clinic | 3072414333 | Practice locations: Manistee, MI |
National Provider Directory
- Part of
- Munson Manor Hospitality House
Locations
375 River St
Manistee, MI 49660
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1293 E Parkdale Ave
Manistee, MI 49660-8904
Mailing address
1293 E Parkdale Ave
Manistee, MI 49660-8904
Phone (231) 398-1840
Other providers in Manistee, MI
- Lisa Morris
- Munson Healthcare Manistee
- Munson Healthcare Manistee Hospital
- Munson Healthcare Manistee Hospital
- Munson Healthcare Manistee Hospital
- Munson Healthcare Manistee Hospital
- Munson Healthcare Manistee Hospital
- Laura-Jane C. Murphy
- Gwendolyn A Nelson
- Julia Nelson
All providers in Manistee, MI · Rural Health Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2026. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.