Michigan-Wisconsin Family Practice Associates, P.C.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MICHIGAN-WISCONSIN FAMILY PRACTICE ASSOCIATES, P.C.

Practice address

1711 S Stephenson Ave
Suite 300
Iron Mountain, MI 49801-3650

Phone

(906) 774-1633

Fax

(906) 774-4451

NPI assigned

Sep 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Beth A Schroeder, M.D.NPI 1184616013

Title

Owner

Phone

(906) 774-1633

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Rural health clinic certification: CCN 233872

Legal name

MICHIGAN-WISCONSIN FAMILY PRACTICE ASSOCIATES, P.C.

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

May 23, 1995

Last certification

Jul 14, 2021

Ownership / control type

1B

Most recent change of ownership

Aug 1, 2006 (1 total)

Organization structure

CorporationProprietary

Incorporated

Sep 1, 1985 in MI

Enrollment address

1711S Stephenson Ave
Suite 300
Iron Mountain, MI 49801-3650

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Beth Ann Schroeder, M.D.

  • Family Medicine Physician
  • Iron Mountain, MI
  • NPI 1184616013

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beth Ann Schroeder, M.D.

  • Family Medicine Physician
  • Iron Mountain, MI
  • NPI 1184616013
  Medicare reassignment Care Compare group NPD Authorized official
• Kristi Rae Olson, M.D.

  • Family Medicine Physician
  • Iron Mountain, MI
  • NPI 1265480297
  Medicare reassignment Care Compare group NPD
• Sarah J Petschar, NP

  • Family Nurse Practitioner
  • Iron Mountain, MI
  • NPI 1700426384
  Medicare reassignment Care Compare group NPD
• Karen M Steber, FNP

  • Family Nurse Practitioner
  • Iron Mountain, MI
  • NPI 1992725493
  Medicare reassignment Care Compare group NPD
• Katie Brown

  • Physician Assistant
  • Grand Rapids, MI
  • NPI 1063747343
  Medicare reassignment
• Heather Lynn Hayes, PA-C

  • Physician Assistant
  • Iron Mountain, MI
  • NPI 1447449053
  Medicare reassignment

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1972605913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE",
            "address_2": "SUITE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE",
            "address_2": "SUITE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN-WISCONSIN FAMILY PRACTICE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "906-774-1633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43055200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Erwin Merrill, D.O.
• Mitzi Faye Metzler, M.S., R.D., C.D.E.
• Michael Occhietti MD PC
• Stephanie L Michaels, LPN
• Samantha Micheau
• Michigan-Wisconsin Family Practice Associates, P.C.
• Andrea L Millan, CRD CD REGISTERED CE
• Pamela Noel Miller
• Brooke R Minerick, CRNA
• Rajesh Mital, MD

• Rural Health Clinic/Center in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Rural Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.