NPIMap

Organization Active NPI

Munson Healthcare Charlevoix Hospital

  • Pediatrics Physician
  • Charlevoix, MI
National Provider Identifier
1992074777
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
Practice address
14734 Park Ave
Charlevoix, MI 49720-1927
Phone
(231) 547-6554
Fax
(231) 547-1179
NPI assigned
Dec 22, 2011
Organization subpart
Yes
Parent organization
MUNSON HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

14734 Park Ave
Charlevoix, MI 49720-1927

Mailing address

14734 Park Ave
Charlevoix, MI 49720-1927
Phone (231) 547-6554

Other names 1

  • Munson Healthcare Charlevoix Pediatrics Doing business as

National Provider Directory

National Provider Directory
Part of
Munson Manor Hospitality House

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

14734 Park Ave
Charlevoix, MI 49720
Phone (231) 547-4024

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1992074777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14734 PARK AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201927",
            "telephone_number": "231-547-6554",
            "fax_number": "231-547-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14734 PARK AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201927",
            "telephone_number": "231-547-6554",
            "fax_number": "231-547-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE CHARLEVOIX HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUNSON HEALTHCARE",
        "enumeration_date": "2011-12-22",
        "last_updated": "2016-03-07",
        "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": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munson Healthcare Charlevoix Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlevoix, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.