Beaver Island Rural Health Center | |
37304 Kings Hwy Beaver Island MI 49782-9792 | |
(231) 448-2275 | |
(231) 448-2348 |
Full Name | Beaver Island Rural Health Center |
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Speciality | Clinic/Center |
Location | 37304 Kings Hwy, Beaver Island, Michigan |
Authorized Official Name and Position | Donna Kubic (MANAGING DIRECTOR) |
Authorized Official Contact | 2314482275 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Beaver Island Rural Health Center 37304 Kings Hwy Beaver Island MI 49782-9792 Ph: (231) 448-2275 | Beaver Island Rural Health Center 37304 Kings Hwy Beaver Island MI 49782-9792 Ph: (231) 448-2275 |
NPI Number | 1407828080 |
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Provider Enumeration Date | 02/07/2006 |
Last Update Date | 01/23/2013 |
Medicare PECOS PAC ID | 3971539156 |
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Medicare Enrollment ID | O20050711000160 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407828080 | NPI | - | NPPES |
1407828080 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | John D Martin |
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Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1831128180 PECOS PAC ID: 1052206596 Enrollment ID: I20040302000775 |
Provider Name | Cecilia L Peasley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164445524 PECOS PAC ID: 4183514250 Enrollment ID: I20040319001352 |
Provider Name | Daniel Mathew Mann |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306838081 PECOS PAC ID: 8022168079 Enrollment ID: I20100827000236 |
Provider Name | Kelly Noel Becker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629355813 PECOS PAC ID: 3375703002 Enrollment ID: I20120404000335 |
Provider Name | Terry L Braciszewski |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1386656023 PECOS PAC ID: 5991955478 Enrollment ID: I20121017000947 |
Provider Name | Joan A Matejovsky |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750857934 PECOS PAC ID: 6800140492 Enrollment ID: I20181119000431 |
Provider Name | Brandon M Vincent |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275092561 PECOS PAC ID: 9133461130 Enrollment ID: I20190423001033 |
Provider Name | Jason John Brown |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1912345984 PECOS PAC ID: 7911136007 Enrollment ID: I20210106003197 |
Provider Name | Tammy Radionoff |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245719194 PECOS PAC ID: 2163844184 Enrollment ID: I20210224001336 |
Provider Name | Timothy King |
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Provider Type | Practitioner - Pain Management |
Provider Identifiers | NPI Number: 1215963202 PECOS PAC ID: 5395638159 Enrollment ID: I20230203001748 |