Individual provider Active NPI

Krista S Anhalt, DO

  • Emergency Medicine Physician
  • Cheboygan, MI
National Provider Identifier
1952445397
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101015064 Issued in MI
Practice address
748 S Main St
Cheboygan, MI 49721-2220
Phone
(231) 487-2490
NPI assigned
Feb 19, 2007
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101015064 MI Primary

Addresses

Primary practice location

748 S Main St
Cheboygan, MI 49721-2220

Mailing address

4100 Embassy Dr SE Ste 400
Grand Rapids, MI 49546-2416
Phone (616) 975-1845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051006000665 MI Practitioner - Emergency Medicine 3971528167 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interlochen Emergency Group PCGroup PAC ID 3577918606, 49 clinicians
Caberfae Emergency Group PCGroup PAC ID 4082069232, 39 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

1465 E Parkdale Ave
Manistee Hospital
Manistee, MI 49660-9709
Phone (231) 398-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101015064MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interlochen Emergency Group, P.C. Emergency Medicine CurrentSince Dec 10, 2023 Accepting new patients
Caberfae Emergency Group, P.C. Emergency Medicine CurrentSince Nov 8, 2023 Accepting new patients

Locations

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

224 Park Ave
Frankfort, MI 49635
Phone (231) 352-2200

1465 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1000

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1952445397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EMBASSY DR SE STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462416",
            "telephone_number": "616-975-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 S MAIN ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212220",
            "telephone_number": "231-487-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANHALT",
        "first_name": "KRISTA",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2023-11-10",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101015064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheboygan, MI

Sources for this page

Verify at the official NPI Registry.