Organization Active NPI

Lakeshore Ear and Hearing Associates LLC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Grand Haven, MI
National Provider Identifier
1013236215
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
Legal business name
LAKESHORE EAR AND HEARING ASSOCIATES LLC
Practice address
1101 Columbus Ave
Grand Haven, MI 49417-1556
Phone
(616) 847-3144
NPI assigned
May 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2010

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

Authorized official

Name
Kristin Kay Johnston
Title
Co-Owner
Phone
(616) 847-3144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0007X Primary

Addresses

Primary practice location

1101 Columbus Ave
Grand Haven, MI 49417-1556

Mailing address

1101 Columbus Ave
Grand Haven, MI 49417-1556
Phone (616) 847-3144

National Provider Directory

National Provider Directory

Locations

1101 Columbus Ave
Grand Haven, MI 49417
Phone (616) 847-3144

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274918400000",
    "number": "1013236215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 COLUMBUS AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171556",
            "telephone_number": "616-847-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 COLUMBUS AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171556",
            "telephone_number": "616-847-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE EAR AND HEARING ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-27",
        "last_updated": "2010-05-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "616-847-3144"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.