| Nottawaseppi Huron Band Of The Potawatomi | |
|
4415 Byron Center Ave Sw Wyoming MI 49519-4800 | |
| (616) 249-0159 | |
| (616) 249-8688 |
| Full Name | Nottawaseppi Huron Band Of The Potawatomi |
|---|---|
| Speciality | Clinic/Center |
| Location | 4415 Byron Center Ave Sw, Wyoming, Michigan |
| Authorized Official Name and Position | Rosalind Johnston (HEALTH DIRECTOR) |
| Authorized Official Contact | 2697294422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nottawaseppi Huron Band Of The Potawatomi 1474 Mno - Bmadzewen Way Fulton MI 49052-9602 Ph: (269) 729-4422 | Nottawaseppi Huron Band Of The Potawatomi 4415 Byron Center Ave Sw Wyoming MI 49519-4800 Ph: (616) 249-0159 |
| NPI Number | 1770500548 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 07/09/2015 |
| Medicare PECOS PAC ID | 2769441286 |
|---|---|
| Medicare Enrollment ID | O20041008000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770500548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | 18732 (Michigan) | Primary |
| Provider Name | Jolane S Conklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669775821 PECOS PAC ID: 8123266335 Enrollment ID: I20130530000021 |
| Provider Name | Tadd A Heft |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932144045 PECOS PAC ID: 3274433909 Enrollment ID: I20140320001194 |
| Provider Name | Erin Anne Stark |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1609349315 PECOS PAC ID: 0648511931 Enrollment ID: I20190415002434 |
| Provider Name | Cassie Cleary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134548951 PECOS PAC ID: 7719315266 Enrollment ID: I20200316000476 |
| Provider Name | Nichol Bremer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427242320 PECOS PAC ID: 9638315930 Enrollment ID: I20200319001881 |
| Provider Name | Renuka C Haugen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093906448 PECOS PAC ID: 6800977125 Enrollment ID: I20200622000151 |
| Provider Name | David K Hivale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578816765 PECOS PAC ID: 4183876501 Enrollment ID: I20201030000429 |
| Provider Name | Angela Gingerich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083074462 PECOS PAC ID: 5890184337 Enrollment ID: I20211122003029 |
| Provider Name | Lisa Hoekstra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063518785 PECOS PAC ID: 7517941941 Enrollment ID: I20220127000090 |
| Provider Name | Jonathan Rinehart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295359081 PECOS PAC ID: 4486049921 Enrollment ID: I20220318000826 |
| Provider Name | Keyana Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578170320 PECOS PAC ID: 8628480720 Enrollment ID: I20230614003471 |
| Provider Name | Emilia Marton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972829802 PECOS PAC ID: 9436591393 Enrollment ID: I20240523000177 |
| Provider Name | Kallie Howell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952792244 PECOS PAC ID: 9739521691 Enrollment ID: I20240523000396 |
| Provider Name | Tonisha Begay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801560529 PECOS PAC ID: 5890133755 Enrollment ID: I20250506000705 |
Jasper Health Worx Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5960 Burlingame Ave Sw Ste A, Wyoming, MI 49509 Phone: 877-291-6488 | |
Metropolitan Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 781 36th St Se, Wyoming, MI 49548 Phone: 616-252-4100 Fax: 616-252-4953 | |
Catherines Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 950 36th St Sw, Wyoming, MI 49509 Phone: 616-336-8800 | |
Midwest Family Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1009 44th St Sw, Suite A1, Wyoming, MI 49509 Phone: 800-968-6866 | |
Pediatrics Primary Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4433 Byron Center Ave Sw, Pediatrics Primary Care, Wyoming, MI 49519 Phone: 616-530-2846 Fax: 616-530-2854 | |
Allen Surgical Care, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1009 44th St Sw Ste 101, Wyoming, MI 49509 Phone: 616-828-4622 | |
Brookville Pediatric & Internal Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 56th St Sw, Wyoming, MI 49509 Phone: 616-243-5707 Fax: 616-243-1170 |