NPIMap

Organization Active NPI

Ecs Northern Michigan PC

  • Emergency Medicine Physician
  • Petoskey, MI
National Provider Identifier
1992231377
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ECS NORTHERN MICHIGAN PC
Practice address
416 Connable Ave
Petoskey, MI 49770
Phone
(800) 248-6777
NPI assigned
May 4, 2017
Last updated
Dec 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Tammy Munger
Title
Cfo
Phone
(616) 988-8225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

416 Connable Ave
Petoskey, MI 49770

Mailing address

PO Box 30516
Dept 4101
Lansing, MI 48909-8016

Other practice location 1

748 S Main St
Cheboygan, MI 49721-2220
Phone (231) 487-2490

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170627001889 MI Part B Supplier - Clinic/Group Practice 3173892627 Receives reassigned benefits from 54 practitioners
Practice locations: Cheboygan, MI; Petoskey, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 54

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.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1992231377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 4101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 CONNABLE AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "800-248-6777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "748 S Main St",
            "address_purpose": "LOCATION",
            "city": "Cheboygan",
            "state": "MI",
            "postal_code": "497212220",
            "country_code": "US",
            "telephone_number": "231-487-2490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ECS NORTHERN MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-04",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "MUNGER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-988-8225"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.