NPIMap

Organization Active NPI

County of Lapeer

  • Community Health Registered Nurse
  • Lapeer, MI
National Provider Identifier
1013088079
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
23D0650909 Issued in MI
Legal business name
COUNTY OF LAPEER
Practice address
1800 Imlay City Rd
Lapeer, MI 48446-3208
Phone
(810) 245-5711
Fax
(810) 245-4525
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Authorized official

Name
Ms. Stephanie Simmons, BSN, MPA
Title
Director Health Officer
Phone
(810) 245-5581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WC1500X 23D0650909 MI Primary

Addresses

Primary practice location

1800 Imlay City Rd
Lapeer, MI 48446-3208

Mailing address

1800 Imlay City Rd
Lapeer, MI 48446-3208
Phone (810) 245-5711

Other identifiers 3

IdentifierTypeStateIssuer
4695060MedicaidMI
1845691MedicaidMI
5100546MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101220000615 MI Part B Supplier - Mass Immunization (Roster Biller Only) 4183533193 Practice locations: Lapeer, MI

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lapeer County Community Mental Health8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lapeer County Medical Care FacilityLapeer, MI, CCN 235058 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1971

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1013088079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 IMLAY CITY RD",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484463208",
            "telephone_number": "810-245-5711",
            "fax_number": "810-245-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 IMLAY CITY RD",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484463208",
            "telephone_number": "810-245-5711",
            "fax_number": "810-245-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAPEER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR HEALTH OFFICER",
        "authorized_official_telephone_number": "810-245-5581",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSN, MPA"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "MI",
            "license": "23D0650909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4695060",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1845691",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100546",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

Verify at the official NPI Registry.