MICHIGAN STATE UNIVERSITY (NPI# 1760561658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760561658 |
| Entity Type | Organization |
| Organization Name | MICHIGAN STATE UNIVERSITY |
| Other Organization Name | OSTEOPATHIC MANIPULATIVE MEDICINE CLINIC |
| Practice Address |
804 Service Rd Ste A233 East Lansing MI 48824-7015 |
| Mailing Address |
D128 West Fee Hall East Lansing MI 48824-1315 |
| Practice Telephone | 5174326144 |
| Practice Fax Number | 5174326150 |
| Mailing Telephone | 5173553503 |
| Mailing Fax Number | 5174321167 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2016-06-06 |
| Authorized Official Name | KAREN L. ROMIG (PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 5178842976 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Osteopathic Manipulative Medicine Clinic | Other Name - Individual/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 |
| 1629307251 | Michigan State University | Preventive Medicine | 346 Olin Health Ctr, East Circle Drive, East Lansing, MI 48824-1037 | 2009-12-10 |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MICHIGAN STATE UNIVERSITY | 426 Auditorium Rd, East Lansing, MI 48824-2600 |
| Massachusetts Corporations | MICHIGAN STATE UNIVERSITY ALUMNI CLUB OF BOSTON, INC. | 2001 Dogwood Circle, North Andover, MA 01845 |
| 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 |
804 SERVICE RD STE A233 |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48824-7015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457355042 | Elizabeth Hengstebeck | Family Medicine | 804 Service Rd, A142, East Lansing, MI 48824-7015 | 2005-06-10 |
| 1467906271 | Barbara Mitchell | Nurse Practitioner | 804 Service Rd, A217, East Lansing, MI 48824-7015 | 2016-08-09 |
| 1578946406 | Prajwal Dhakal | Internal Medicine | 804 Service Rd, A225, East Lansing, MI 48824-7015 | 2015-07-09 |
| 1184007890 | Omar Albanyan | Internal Medicine | 804 Service Rd, A225 Clinical Center, East Lansing, MI 48824-7015 | 2015-06-30 |
| 1942681226 | Laura Bohatch | Internal Medicine | 804 Service Rd, A-225 Clinical Center, East Lansing, MI 48824-7015 | 2015-06-12 |
| 1225417850 | Georgette Cooke | Internal Medicine | 804 Service Rd, A-225 Clinical Center, East Lansing, MI 48824-7015 | 2015-05-28 |
| 1326427931 | Negar Salehi | Internal Medicine | 804 Service Rd, A-225 Clinical Center, East Lansing, MI 48824 | 2015-05-28 |
| 1871900563 | Tariq Khalid Alrasheed | Internal Medicine | 804 Service Rd, Room A-225, East Lansing, MI 48824-7021 | 2014-07-15 |
| 1851716732 | Christie Daiss | Pharmacist | 804 Service Rd, A-101, East Lansing, MI 48824-7021 | 2014-02-28 |
| 1538583380 | Jane French | Pharmacist | 804 Service Rd, East Lansing, MI 48824-7021 | 2014-02-14 |
| Find all providers in the same location | ||||
| 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 | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689297756 | Nathan Barnhurst | Neuromusculoskeletal Medicine & OMM | 4660 Hagadorn Rd #500, East Lansing, MI 48823 | 2020-05-25 |
| 1154351542 | Christopher Adam Pohlod | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2006-07-03 |
| 1740803121 | Kathleen Claire Stenlund | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2020-05-20 |
| 1457974073 | Leah Goedecke | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2020-05-19 |
| 1285257824 | Amanda Leigh Robinson | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2020-05-18 |
| 1083246052 | Msu Health Care Inc | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2020-02-07 |
| 1437631140 | Jared Michael Ham-ying | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2018-08-30 |
| 1811482433 | Scott Michael Wilkie | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2018-06-26 |
| 1558855262 | Kyle Lamont Allan | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd, East Lansing, MI 48823-5376 | 2018-06-15 |
| 1164942843 | Brittany Renee Breitzke | Neuromusculoskeletal Medicine & OMM | 4660 S Hagadorn Rd Ste 500, East Lansing, MI 48823-6804 | 2017-06-22 |
| 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.