MICHIGAN STATE UNIVERSITY (NPI# 1629307251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629307251 |
| Entity Type | Organization |
| Organization Name | MICHIGAN STATE UNIVERSITY |
| Other Organization Name | UNIVERSITY PHYSICIANS OFFICE |
| Practice Address |
346 Olin Health Ctr East Circle Drive East Lansing MI 48824-1037 |
| Practice Telephone | 5173539101 |
| Practice Fax Number | 5173550332 |
| Mailing Telephone | 5173539101 |
| Mailing Fax Number | 5173550332 |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2009-12-10 |
| Authorized Official Name | ELIZABETH ALEXANDER (UNIVERSITY PHYSICIAN) |
| Authorized Official Telephone | 5173539101 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
4301051230 | MI | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 4301054986 | MI | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| University Physicians Office | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184182982 | Michigan State University | Local Education Agency (LEA) | 446 W. Circle Drive, Room 409, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824-1039 | 2019-03-11 |
| 1427443274 | Michigan State University | Behavioral Analyst | 325 W Grand River Ave, East Lansing, MI 48823 | 2015-03-30 |
| 1295978054 | Michigan State University | Clinical Medical Laboratory | 1355 Bogue St Rm B228, East Lansing, MI 48824-6207 | 2009-04-09 |
| 1487780565 | Michigan State University | Clinical Medical Laboratory | B228 Life Sciences Bldg, East Lansing, MI 48824 | 2007-02-26 |
| 1518046598 | Michigan State University | Clinic/Center | 804 Clinical Center, A114, East Lansing, MI 48824-1313 | 2006-11-02 |
| 1639253784 | Michigan State University | Registered Nurse | 804 Service Rd Ste A142, East Lansing, MI 48824-7015 | 2006-10-25 |
| 1962515221 | Michigan State University | Pharmacy | 463 E Circle Dr. Rm103, East Lansing, MI 48824 | 2006-08-17 |
| 1992712053 | Michigan State University | Occupational Therapist | 4660 S Hagadorn Rd Ste 400, East Lansing, MI 48823-5353 | 2006-08-02 |
| 1891747614 | Michigan State University | Radiology | 804 Service Rd # D100, East Lansing, MI 48824-7015 | 2006-05-17 |
| 1861443269 | Michigan State University | Family Medicine | 804 Service Rd # A225, East Lansing, MI 48824-7015 | 2006-05-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MICHIGAN STATE UNIVERSITY | 426 Auditorium Rd, East Lansing, MI 48824-2600 |
| Virginia Business Entities | Michigan State University Alumni Club of Metropolitan Washington DC | 10511 Judicial Drive, Fairfax, Virginia 22030-5172 |
| System for Award Management (SAM) Entities | MICHIGAN STATE UNIVERSITY FOUNDATION | 2727 Alliance Dr Ste C, Lansing, MI 48910-3868 |
| Street Address |
346 OLIN HEALTH CTR EAST CIRCLE DRIVE |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48824-1037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680303 | Emilia Elizabeth Mattioli | Psychiatry & Neurology | 965 Fee Road Room A223, East Lansing, MI 48824 | 2020-05-14 |
| 1447871983 | James O'brien | Psychiatry & Neurology | Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2020-05-06 |
| 1750916979 | Mulin Xiong | Student in an Organized Health Care Education/Training Program | 965 Wilson Road Suite A110, East Fee Hall, East Lansing, MI 48824 | 2020-03-09 |
| 1821659301 | Tovah Apolonia Aho | Psychiatry & Neurology | Michigan State University Psychiatric Residency, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-06-25 |
| 1912564881 | Asmara Theresa Hoo | Psychiatry & Neurology | 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-05-24 |
| 1790276822 | Traverse Health Clinic and Coalition | Clinic/Center | East Fee Hall 965 Fee Road, Room A222, East Lansing, MI 48824 | 2018-05-24 |
| 1922598515 | Jubin Joseph Cheruvelil | Specialist/Technologist, Other | 446 W. Circle Dr. Room 249 Annex, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824 | 2018-05-18 |
| 1073003257 | Dawn Arvye Contreras | Health Educator | 446 West Circle Dr., Justin S. Morrill Hall of Agriculture, Room 166, East Lansing, MI 48824 | 2018-05-14 |
| 1710406046 | Kimberly Ann Breukink | Social Worker | 463 East Circle Drive, Michigan State University, Counseling and Psychiatric Services, East Lansing, MI 48824 | 2017-09-19 |
| 1043766314 | Ahmed Jouan | Psychiatry & Neurology | 804 Service Rd A217, East Lansing, MI 48824 | 2016-08-28 |
| Find all providers in zip 48824 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730740507 | Hannah Finnerty | Family Medicine | 2852 Eyde Pkwy Ste 175, East Lansing, MI 48823-5378 | 2019-06-24 |
| 1588158869 | Ralph A. Harvey Md, Pllc | Family Medicine | 1350 E Lake Lansing Rd Ste C, East Lansing, MI 48823-7413 | 2018-06-19 |
| 1972999365 | Jennifer Renee Mccaskill | Family Medicine | 2900 Hannah Blvd Ste 216, East Lansing, MI 48823 | 2015-04-13 |
| 1124111026 | Full Spectrum Family Medicine PC | Family Medicine | 2025 Abbot Rd, Suite 100, East Lansing, MI 48823-8573 | 2006-10-02 |
| 1972609683 | Mary Elizabeth Thorne | Family Medicine | 1280 Chartwell Carriage Way North, East Lansing, MI 48823-2404 | 2006-09-16 |
| 1477658565 | William Holding Page-echols | Family Medicine | 2025 Abbott Rd, Suite 100, East Lansing, MI 48823-8573 | 2006-09-13 |
| 1982706560 | Heidi J. Johnson | Family Medicine | 2035 Asher Ct, Suite 200, East Lansing, MI 48823-8480 | 2006-09-02 |
| 1396859013 | Carol Lynn Monson | Family Medicine | 804 Clinical Center, A235, East Lansing, MI 48824 | 2006-08-19 |
| 1689602971 | Michael J Chamot | Family Medicine | 107 Olin Health Center, East Circle Dr, East Lansing, MI 48824-1037 | 2006-06-28 |
| 1346276144 | David Todd Walsworth | Family Medicine | 804 Service Rd # A142, East Lansing, MI 48824-7015 | 2006-06-23 |
| Find all providers in EAST LANSING | ||||
| City | EAST LANSING |
| Zip Code | 48824 |
Please comment or provide details below to improve the information on MICHIGAN STATE UNIVERSITY.
| 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.