NPIMap

Organization Active NPI

Edwared W. Sparrow Hospital

Doing business as Physicial Medicine & Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Lansing, MI
National Provider Identifier
1881640548
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
EDWARED W. SPARROW HOSPITAL
Doing business as
Physicial Medicine & Rehabilitation
Practice address
1200 E Michigan Ave
Suite 570
Lansing, MI 48912-1800
Phone
(517) 364-5260
Fax
(517) 364-5296
NPI assigned
May 25, 2006
Last updated
Mar 6, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
EDWARD W. SPARROW HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Mr. Chris Eugene Bergman
Title
Senior Vice President / Cfo
Phone
(517) 364-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1200 E Michigan Ave
Suite 570
Lansing, MI 48912-1800

Mailing address

PO Box 13008
Lansing, MI 48901-3008
Phone (517) 364-6253

Other names 1

  • Physicial Medicine & Rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040102000790 MI Part B Supplier - Clinic/Group Practice 6709799166 Receives reassigned benefits from 965 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lansing, MI; Mason, MI; Okemos, MI; Owosso, MI; Saint Johns, MI; Williamston, MI; Carson City, MI; Charlotte, MI…

Other NPIs on the same Medicare enrollment 34

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

View all 34

National Provider Directory

National Provider Directory
Part of
Geraldine Wegnerfritz C

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1881640548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13008",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489013008",
            "telephone_number": "517-364-6253",
            "fax_number": "517-364-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE",
            "address_2": "SUITE 570",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121800",
            "telephone_number": "517-364-5260",
            "fax_number": "517-364-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARED W. SPARROW HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDWARD W. SPARROW HOSPITAL",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT / CFO",
        "authorized_official_telephone_number": "517-364-5400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicial Medicine & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.