NPIMap

Organization Active NPI

Munson Medical Center

Doing business as T Schermerhorn MD

  • Neurological Surgery Physician
  • Traverse City, MI
National Provider Identifier
1922023647
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
MUNSON MEDICAL CENTER
Doing business as
T Schermerhorn MD
Practice address
1221 6TH St
Suite 100
Traverse City, MI 49684-2359
Phone
(231) 392-0460
Fax
(231) 392-0643
NPI assigned
Jul 13, 2006
Last updated
Dec 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Authorized official

Name
Mark Hepler
Title
Cfo
Phone
(231) 935-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X MI Primary

Addresses

Primary practice location

1221 6TH St
Suite 100
Traverse City, MI 49684-2359

Mailing address

1221 6TH St
Suite 100
Traverse City, MI 49684-2359
Phone (231) 392-0460

Other identifiers 3

IdentifierTypeStateIssuer
CB9942OtherMIRAIL ROAD GROUP NUMBER
700B860160OtherMIBCBS MICHIGAN GROUP
TS083353OtherMIBCBS LICENSE

Other names 1

  • T SCHERMERHORN MD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000904 MI Part B Supplier - Clinic/Group Practice 3072426287 Receives reassigned benefits from 568 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manistee, MI; Traverse City, MI; Cadillac, MI; Charlevoix, MI; Cheboygan, MI; Elk Rapids, MI; Frankfort, MI; Gaylord, MI…

Other NPIs on the same Medicare enrollment 29

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

View all 29

National Provider Directory

National Provider Directory
Tax ID family
Leroy Futterer MD30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Locations

1221 Sixth St
Ste 100
Traverse City, MI 49684
Phone (231) 392-8400

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1922023647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 6TH ST",
            "address_2": "SUITE 100",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842359",
            "telephone_number": "231-392-0460",
            "fax_number": "231-392-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 6TH ST",
            "address_2": "SUITE 100",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842359",
            "telephone_number": "231-392-0460",
            "fax_number": "231-392-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "HEPLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "231-935-5000"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD GROUP NUMBER",
            "identifier": "CB9942",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MICHIGAN GROUP",
            "identifier": "700B860160",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS LICENSE",
            "identifier": "TS083353",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "T SCHERMERHORN MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.