PINE RIVER MEDICAL ASSOCIATES, P.C. (NPI# 1538102694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538102694 |
| Entity Type | Organization |
| Organization Name | PINE RIVER MEDICAL ASSOCIATES, P.C. |
| Practice Address |
14734 Park Ave Charlevoix MI 49720 |
| Practice Telephone | 2315476554 |
| Mailing Telephone | 2315476554 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. PAMELA M NEWCOMB (HUMAN RESOURCE OFFICER) |
| Authorized Official Telephone | 2315476554 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | DJ033990 | MI | Other Service Providers |
| N | 174400000X | Specialist | FS039750 | MI | Other Service Providers |
| N | 174400000X | Specialist | EN 045102 | MI | Other Service Providers |
| N | 174400000X | Specialist | DM 076754 | MI | Other Service Providers |
| N | 174400000X | Specialist | MB 070397 | MI | Other Service Providers |
| N | 174400000X | Specialist | JM 066688 | MI | Other Service Providers |
| Y | 174400000X | Specialist | RT 046881 | MI | Other Service Providers |
| Street Address |
14734 PARK AVE |
| City | CHARLEVOIX |
| State | MI |
| Zip Code | 49720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151212 | Roderic E Tinney | Pediatrics | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2005-08-18 |
| 1558904623 | Munson Healthcare Charlevoix Hospital | Clinic/Center | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2019-10-22 |
| 1114368321 | Chris Loewen | Family Medicine | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2013-07-16 |
| 1992074777 | Munson Healthcare Charlevoix Hospital | Pediatrics | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2011-12-22 |
| 1013173392 | Rachel Beth Newman | Pediatrics | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2008-08-05 |
| 1952596637 | Munson Healthcare Charlevoix Hospital | Emergency Medicine | 14734 Park Ave, Charlevoix, MI 49720-1931 | 2007-09-06 |
| 1063598845 | Munson Healthcare Charlevoix Hospital | Nurse Anesthetist, Certified Registered | 14734 Park Ave, Charlevoix, MI 49720-1931 | 2006-10-27 |
| 1750484879 | Mark William Smith | Family Medicine | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2006-09-06 |
| 1649291048 | Cynthia Statler | Pediatrics | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2006-07-21 |
| 1659363299 | Melodie R Brown | Family Medicine | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2005-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1215587498 | Amanda Evans | Dietitian, Registered | 09210 North Pointe Woods Drive, Charlevoix, MI 49720 | 2019-09-18 |
| 1508229980 | Charlevoix Physicians Clinic | Specialist | 14709 W. Upright, Charlevoix, MI 49720 | 2016-04-01 |
| 1881014348 | Tracy Skinner | Social Worker | 220 W. Garfield Ave, Charlevoix, MI 49720 | 2014-04-23 |
| 1720414097 | Jennifer Jean Swenor | Occupational Therapist | 10270 Burnett Rd, Charlevoix, MI 49720 | 2013-09-18 |
| 1801171863 | Leslie Lukins | Pharmacist | 1500 Bridge Street, Charlevoix, MI 49720 | 2011-10-20 |
| 1164670949 | Northwest Michigan Community Health Agency | Hospice Care, Community Based | 220 W Garfield Street, Charlevoix, MI 49720 | 2008-09-04 |
| 1275722191 | Robert Dennis Cook | Pharmacist | 301 Bridge Street, Charlevoix, MI 49720 | 2007-10-16 |
| 1629191648 | Susan Mary Killam | Nurse Practitioner | Northwest Michigan Community Health Agency, 220 W. Garfield Street, Charlevoix, MI 49720 | 2007-04-06 |
| 1851410153 | Joelle M Beaudoin | Specialist/Technologist | 06510 M-66 N, Charlevoix, MI 49720 | 2007-03-28 |
| Find all providers in zip 49720 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508229980 | Charlevoix Physicians Clinic | Specialist | 14709 W. Upright, Charlevoix, MI 49720 | 2016-04-01 |
| 1942407705 | Craig D. Wendt, M.d. | Specialist | 14695 Park Ave, Charlevoix, MI 49720-1929 | 2007-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574118 | Gada Santos | Specialist | 10786 Pine St, Taylor, MI 48180-3440 | 2020-10-07 |
| 1750995361 | Advanced Spinal Reconstruction Pllc | Specialist | 972 Chesterfield Ave, Birmingham, MI 48009-1223 | 2020-09-01 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1235765827 | Magic Touch Salon | Specialist | 746 Burton St Se, Grand Rapids, MI 49507-3204 | 2020-03-16 |
| 1144865411 | Yasmeen Global Beauty Group | Specialist | 21701 W 11 Mile Rd Ste 7, Southfield, MI 48076-3713 | 2019-11-11 |
| 1255990552 | Kboose | Specialist | 3008 Juneberry Ave Se, Grand Rapids, MI 49508-1523 | 2019-06-10 |
| 1124685789 | Grooming Arts Lounge and Gallery | Specialist | 19520 Dorset St, Southfield, MI 48075-7112 | 2019-05-20 |
| 1144787326 | At Home Physician Management Group Co. | Specialist | 27440 Hoover Rd Ste C, Warren, MI 48093-7726 | 2019-02-25 |
| 1821561200 | Bailee J Moffitt | Specialist | 913 W Holmes Rd Unit 200, Lansing, MI 48910-0426 | 2019-01-08 |
| 1871064808 | Shanna E Cook | Specialist | 20843 Garden Ln, Ferndale, MI 48220-2217 | 2018-12-17 |
| Find all providers with the same taxonomy | ||||
| City | CHARLEVOIX |
| Zip Code | 49720 |
Please comment or provide details below to improve the information on PINE RIVER MEDICAL ASSOCIATES, P.C..
| 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.