Lakewood Family Medicine PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LAKEWOOD FAMILY MEDICINE PLC

Practice address

382 N 120TH Ave
Holland, MI 49424-2169

Phone

(616) 396-6516

Fax

(616) 396-2513

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Timothy Victor Smith, MDNPI 1295828820

Title

Physician

Phone

(616) 396-6516

Specialties & licenses 1

Addresses

Other identifiers 1

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

Practitioners 27

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

• Timothy Victor Smith

  • Family Medicine Physician
  • Holland, MI
  • NPI 1295828820
  Medicare reassignment Care Compare group NPD Authorized official
• Martin C Berent, MD

  • Family Medicine Physician
  • Holland, MI
  • NPI 1861587362
  Medicare reassignment Care Compare group NPD
• Robert J Bruxvoort, M.D.

  • Family Medicine Physician
  • Holland, MI
  • NPI 1316927775
  Medicare reassignment Care Compare group NPD
• Patrick J Hulst, MD

  • Family Medicine Physician
  • Holland, MI
  • NPI 1831284785
  Medicare reassignment Care Compare group NPD
• Bryce Hunderman, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Holland, MI
  • NPI 1154298529
  Medicare reassignment Care Compare group NPD
• Charlotte Johnson, MD

  • Family Medicine Physician
  • Holland, MI
  • NPI 1235209651
  Medicare reassignment Care Compare group NPD
• Aaron Kooienga, FNP

  • Family Nurse Practitioner
  • Holland, MI
  • NPI 1053148833
  Medicare reassignment Care Compare group NPD
• Jon W Kroeze, MD

  • Family Medicine Physician
  • Holland, MI
  • NPI 1053405548
  Medicare reassignment Care Compare group NPD
• Kurt Allen Lindberg, MD

  • Family Medicine Physician
  • Holland, MI
  • NPI 1447344973
  Medicare reassignment Care Compare group NPD
• Daniel Merck

  • Family Medicine Physician
  • Grand Rapids, MI
  • NPI 1164080669
  Medicare reassignment Care Compare group NPD
• Jill Miedema, MD

  • Family Medicine Physician
  • Holland, MI
  • NPI 1083737969
  Medicare reassignment Care Compare group NPD
• Lisa Anne Ondersma, A-GNP

  • Adult Health Nurse Practitioner
  • Holland, MI
  • NPI 1457801250
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541721600000",
    "number": "1073609392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 N 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242169",
            "telephone_number": "616-396-6516",
            "fax_number": "616-396-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 N 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242169",
            "telephone_number": "616-396-6516",
            "fax_number": "616-396-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD FAMILY MEDICINE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-11-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "616-396-6516",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI GROUP NUMBER",
            "identifier": "080G06011",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Senior Care LLC
• Lakeshore Sleep Solutions, PLLC
• Lakeshore Surgical Associates PC
• Lakeside ENT, P.C.
• Lakewood Counseling
• Amy R. Lalick, DDS
• Cindy Sue Laman, 5202007180
• Mark S. Laman, PH.D.
• Abigail Jean Lamar, CPNP
• Erin Elizabeth Lamb, PT, MSPT

• Family Medicine Physician in Holland, MI
• Providers in Holland, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.