Lakeshore Internal Medicine and Pediatric Associates

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

4301066494 Issued in MI

Legal business name

LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES

Practice address

437 North 120TH Ave
Holland, MI 49424

Phone

(616) 738-0737

NPI assigned

Aug 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barbara Martin, CPC

Title

Billing

Phone

(616) 453-6329

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Drozdowski, MD

  • Internal Medicine Physician
  • Holland, MI
  • NPI 1063493260
  Medicare reassignment Care Compare group NPD
• Tricia R Miller, MD

  • Pediatrics Physician
  • Holland, MI
  • NPI 1033226618
  Medicare reassignment Care Compare group NPD
• Gregory A Schrotenboer, MD

  • Pediatrics Physician
  • Holland, MI
  • NPI 1326155904
  Medicare reassignment Care Compare group NPD
• Scott D Parrott, PAC

  • Physician Assistant
  • Zeeland, MI
  • NPI 1114298908
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1003924739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 NORTH 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-738-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 NORTH 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-738-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "616-453-6329",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MI",
            "license": "4301066494",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MI",
            "license": "4301074294",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MI",
            "license": "4301074445",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4193863",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4531728",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4529541",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Allergy PC
• Lakeshore Area Radiation Oncology Center
• Lakeshore Eyecare Center PC
• Lakeshore Family Chiropractic, PLC
• Lakeshore Health Partners
• Lakeshore Plastic and Reconstructive Surgery Associates, P.C.
• Lakeshore Psychological & Counseling Services, PC
• Lakeshore Senior Care LLC
• Lakeshore Sleep Solutions, PLLC
• Lakeshore Surgical Associates PC

• Multi-Specialty Clinic/Center in Holland, MI
• Providers in Holland, MI by specialty
• Multi-Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.