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MIDMICHIGAN MEDICAL OFFICES-BEAVERTON
NPI 1114278140
Clinic/Center - Federally Qualified Health Center (FQHC) in Beaverton, MI

Active since October 01, 2012CLIA Certified · 2 labs
439 S ROSS ST, BEAVERTON, MI 48612(989) 246-3500(989) 246-3519 Get Directions Write a Review

NPPES record last updated: May 20, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Midmichigan Medical Offices-beaverton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIDMICHIGAN MEDICAL OFFICES-BEAVERTON (NPI 1114278140) is a healthcare organization registered as a federally qualified health center (fqhc) in Beaverton, Michigan and active in the NPI registry since October 2012. The organization holds 2 active CLIA laboratory certificates and lists James P Raschke, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1114278140
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameMIDMICHIGAN HEALTH SERVICES
Location Address439 S ROSS STBeaverton, MI 48612-9101
Mailing Address9249 W Lake City RdHoughton Lake, MI 48629-9602 · (989) 422-5122 · Fax (989) 422-4378
Phone(989) 246-3500
Fax(989) 246-3519
Organization SubpartNo
Authorized OfficialJames P RaschkeExecutive Director · (989) 422-5122
Enumeration DateOctober 1, 2012
Last NPPES UpdateMay 20, 2014
✔ NPI 1114278140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
439 S ROSS ST, Beaverton, MI 48612
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Other Names 1

Doing Business AsMidmichigan Medical Offices-beaverton

Other Identifiers 2

Medicare PIN231987MI
Medicare PIN0G27604MI

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2036102

Midmichigan Medical Offices Beaverton · Beaverton, MI
Active · expires Jan 31, 2028
CLIA Number23D2036102
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 1, 2026
Certificate Expiration DateJanuary 31, 2028
Laboratory DirectorRobert Mcmorrow
Laboratory Phone(989) 422-5122
Laboratory LocationMidmichigan Medical Offices Beaverton439 S Ross Street, Beaverton, MI 48612
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D0374773

Midmichigan Medical Offices Roscommon · Roscommon, MI
Active · expires Sep 3, 2027
CLIA Number23D0374773
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateSeptember 4, 2025
Certificate Expiration DateSeptember 3, 2027
Laboratory DirectorRobert Mcmorrow
Laboratory Phone(989) 422-5122
Laboratory LocationMidmichigan Medical Offices Roscommon135 Lake Street, Roscommon, MI 48653
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVEN WOODWARD PICARD MD
Family Medicine
439 S ROSS ST
BEAVERTON, MI 48612
Gladwin County (989) 246-3500
ANN MARIE ROEHRS FNP
Nurse Practitioner (Family)
439 S ROSS ST, MIDMICHIGAN MEDICAL OFFICES-BEAVERTON
BEAVERTON, MI 48612
Gladwin County (989) 246-3500
DANNY D GREIG II M.D.
Family Medicine
439 S ROSS ST
BEAVERTON, MI 48612
Gladwin County (989) 246-3500
SUSAN M KNOERR DNP,FNP
Nurse Practitioner (Family)
439 S ROSS ST
BEAVERTON, MI 48612
Gladwin County (989) 246-3500
MS. ROSEMARY MCCALLUM-HERBERT LMSW, CAAC
Social Worker (Clinical)
439 S ROSS ST
BEAVERTON, MI 48612
Gladwin County (989) 246-3500
VINOSHA BALAKRISHNAN M.D
Family Medicine
439 S ROSS ST
BEAVERTON, MI 48612
Gladwin County (989) 246-3500
AMANDA LYNN CISSE MSW
Social Worker (Clinical)
439 S ROSS ST
BEAVERTON, MI 48612
Gladwin County (989) 422-5122
JENNA M MCCUMMINGS AGPCNP-BC
Nurse Practitioner (Primary Care)
439 S ROSS ST
BEAVERTON, MI 48612
Gladwin County (989) 246-3500

Frequently Asked Questions

What is MIDMICHIGAN HEALTH SERVICES's NPI number?

The NPI number assigned to this healthcare provider is 1114278140, enumerated as an "organization" on October 01, 2012.

Where is the provider located?

The provider is located at 439 S ROSS ST BEAVERTON, MI 48612 and the phone number is (989) 246-3500.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).

What insurance does MIDMICHIGAN HEALTH SERVICES accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.