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
Stanton, MI 48888-9702

Phone

(989) 831-5237

Fax

(989) 831-5522

NPI assigned

Aug 19, 2015

Last updated

Jul 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Liz Mari (John) Braddock, RS MS

Title

Health Officer

Phone

(989) 831-3640

Specialties & licenses 3

Addresses

Other identifiers 5

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 1851386106

  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 1851386106
  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, and the practitioner matching its NPPES authorized official.

• Jenniffer Marie Efaw, N.P.

  • Nurse Practitioner
  • Stanton, MI
  • NPI 1316247935

  Family Medicine

  NPD
• Jennifer E Morse, MD

  • Family Medicine Physician
  • Mt Pleasant, MI
  • NPI 1801805536
  NPD
• Angela C Felton, CHW

  • Case Manager/Care Coordinator
  • Saint Johns, MI
  • NPI 1689444614
  NPD (past)
• Shanna Smith, CHW

  • Community Health Worker
  • Ithaca, MI
  • NPI 1366212342
  NPD (past)

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1851767370",
    "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",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889702",
            "telephone_number": "989-831-5237",
            "fax_number": "989-831-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MICHIGAN DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "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": "Ms.",
        "authorized_official_credential": "RS MS"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4074187185",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2327700",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301078076",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4632776",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "4704187185",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100715",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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
• Montcalm Care Network

• 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.