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  7. NPI Record 1609182013

MYMICHIGAN MEDICAL CENTER GLADWIN
Complete NPI Record 1609182013
General Acute Care Hospital - Critical Access in Gladwin, MI

NPI Status: Active since August 23, 2010

Contact Information

515 QUARTER ST
GLADWIN, MI
ZIP 48624
Phone: (989) 246-6201

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider First Line Business Practice Location Address
  11. Provider Business Practice Location Address City Name
  12. Provider Business Practice Location Address State Name
  13. Provider Business Practice Location Address Postal Code
  14. Provider Business Practice Location Address Country Code If outside U S
  15. Provider Business Practice Location Address Telephone Number
  16. Provider Enumeration Date
  17. Last Update Date
  18. Authorized Official Last Name
  19. Authorized Official First Name
  20. Authorized Official Middle Name
  21. Authorized Official Title or Position
  22. Authorized Official Telephone Number
  23. Healthcare Provider Taxonomy Code 1
  24. Provider License Number 1
  25. Provider License Number State Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Is Organization Subpart
  28. Authorized Official Name Prefix Text
  29. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1609182013. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1609182013
The fax number associated with the location address of the provider being identified.
Entity Type Code: 2
The date the provider was assigned a unique identifier (assigned an NPI).
Employer Identification Number EIN: UNAVAIL
The date that a record was last updated or changed.
The code designating the provider’s gender if the provider is a person.
Provider First Line Business Mailing Address: 4000 WELLNESS DR
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Mailing Address City Name: MIDLAND
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Mailing Address State Name: MI
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 486702000
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 515 QUARTER ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: GLADWIN
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MI
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 486241959
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9892466201
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 8/23/2010
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 10/25/2022
The date that a record was last updated or changed.
Authorized Official Last Name: STOVER
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: RAYMOND
The first name of the authorized official.
Authorized Official Middle Name: H
The middle name of the authorized official.
Authorized Official Title or Position: PRESIDENT AND CEO
The title or position of the authorized official.
Authorized Official Telephone Number: 9892466201
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 282NC0060X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 260011
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: MI
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: MR.
NPI Certification Date: 10/25/2022