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Organization Active NPI

Munson Healthcare Otsego Memorial Hospital

  • Rural Health Clinic/Center
  • Elmira, MI
National Provider Identifier
1992146807
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL
Doing business as
Munson Healthcare OMH Medical Group-Elmira RHC
OMH Medical Group - Boyne Valley RHC
Practice address
2572 N US Highway 131
Elmira, MI 49730
Phone
(989) 731-7708
NPI assigned
Jul 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Authorized official

Name
Alicia Maitland
Title
Cfo
Phone
(231) 935-7840

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X MI
Rural Health Clinic/Center 261QR1300X Primary
Rural Acute Care Hospital 282NR1301X MI

Addresses

Primary practice location

2572 N US Highway 131
Elmira, MI 49730

Mailing address

829 N Center Ave
Gaylord, MI 49735-1595
Phone (989) 731-7777

Other names 2

  • Munson Healthcare OMH Medical Group-Elmira RHC Doing business as
  • OMH Medical Group - Boyne Valley RHC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Rural health clinic certification: CCN 238662

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MUNSON HEALTHCARE OMH MEDICAL GROUP-ELMIRA RHC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 26, 2013
Last certification
Jan 29, 2020
Ownership / control type
2B
Facility address
2572 N US Highway 131
Elmira, MI 49730
Related CCNs
230133

National Provider Directory

National Provider Directory
Tax ID family
Munson Healthcare Otsego Memorial Hospital32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1992146807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351595",
            "telephone_number": "989-731-7777",
            "fax_number": "989-731-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2572 N US HIGHWAY 131",
            "city": "ELMIRA",
            "state": "MI",
            "postal_code": "49730",
            "telephone_number": "989-731-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-09",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "MAITLAND",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "231-935-7840"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munson Healthcare OMH Medical Group-Elmira RHC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OMH Medical Group - Boyne Valley RHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmira, MI

Sources for this page

Verify at the official NPI Registry.