NORTHWEST MICHIGAN SURGERY CENTER LLC (NPI# 1518957729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518957729 |
| Entity Type | Organization |
| Organization Name | NORTHWEST MICHIGAN SURGERY CENTER LLC |
| Other Organization Name | COPPER RIDGE SURGERY CENTER |
| Practice Address |
4100 Park Forest Drive Traverse City MI 49684-6725 |
| Practice Telephone | 2313928900 |
| Practice Fax Number | 2313928973 |
| Mailing Telephone | 2313928900 |
| Mailing Fax Number | 2313928973 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2019-06-04 |
| Authorized Official Name | TINA L PIOTROWSKI (CEO) |
| Authorized Official Telephone | 2313928950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
286173 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | HEALTH PARTNERS | 104539 | 01 |
| MI | ASR CORP | 487354900 | 01 |
| MI | BLUE CARE NETWORK | P118278 | 01 |
| MI | BLUE CROSS BLUE SHIELD MI | 40340 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 40340 | 01 |
| MI | PRIORITY HEALTH | 38217 | 01 |
| GA | RAILROAD MEDICARE | 00099448 | 01 |
| KY | US DEPT OF LABOR | 487354900 | 01 |
| MI | BLUE CARE NETWORK MI | P118278 | 01 |
| Other Name | Type Code |
|---|---|
| Copper Ridge Surgery Center | Doing Business As Name - Organization |
| Street Address |
4100 PARK FOREST DRIVE |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-6725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699328146 | Alliance Surgery Center, LLC | Clinic/Center | 3663 North Country Drive, Traverse City, MI 49684-4587 | 2019-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1588285050 | Hall Road Asc LLC | Clinic/Center | 11051 Hall Rd Ste 100, Utica, MI 48317-5737 | 2020-05-06 |
| 1235750431 | Precision Surgery Center LLC | Clinic/Center | 22701 Hall Road, Macomb, MI 48042 | 2020-04-29 |
| 1790306991 | Grass Lake Surgery Center LLC | Clinic/Center | 3800 Centennial Blvd, Grass Lake, MI 49240 | 2020-04-29 |
| 1992339147 | Movi Asc Management LLC | Clinic/Center | 5250 Auto Club Drive, Suite 170, Dearborn, MI 48126-2619 | 2020-02-26 |
| 1609409929 | Firestone Procedure Center LLC | Clinic/Center | 4520 Firestone St Ste C, Dearborn, MI 48126-4602 | 2020-02-14 |
| 1255972113 | Center Health Surgery Center LLC | Clinic/Center | 30671 Stephenson Hwy Ste F, Madison Heights, MI 48071-1635 | 2019-10-02 |
| 1942851639 | Northern Michigan Surgical Suites, LLC | Clinic/Center | 825 Moll Dr, Boyne City, MI 49712-9182 | 2019-09-24 |
| 1407313802 | Spectrum Health Hospitals | Clinic/Center | 4069 Lake Dr Se Ste 210, Grand Rapids, MI 49546-8816 | 2019-02-22 |
| 1134685415 | Southfield Surgery Center LLC | Clinic/Center | 26225 Greenfield Road, Southfield, MI 48076-4704 | 2019-02-12 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
Please comment or provide details below to improve the information on NORTHWEST MICHIGAN SURGERY CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.