Active NPI
Lakewood Family Medicine PLC
- Family Medicine Physician
- Holland, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
- Last updated
- Nov 9, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Timothy Victor Smith, MD
- Title
- Physician
- Phone
- (616) 396-6516
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
382 N 120TH Ave
Holland, MI 49424-2169
Mailing address
382 N 120TH Ave
Holland, MI 49424-2169
Phone (616) 396-6516
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0379495 | Lakewood Family Medicine | Provider-performed microscopy | Sep 15, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 27
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Holland, MI
- NPI 1295828820
-
- Family Medicine Physician
- Holland, MI
- NPI 1861587362
-
- Family Medicine Physician
- Holland, MI
- NPI 1316927775
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- Family Medicine Physician
- Holland, MI
- NPI 1831284785
-
- Family Nurse Practitioner
- Holland, MI
- NPI 1154298529
-
- Family Medicine Physician
- Holland, MI
- NPI 1235209651
-
- Family Nurse Practitioner
- Holland, MI
- NPI 1053148833
-
- Family Medicine Physician
- Holland, MI
- NPI 1053405548
-
- Family Medicine Physician
- Holland, MI
- NPI 1447344973
-
- Family Medicine Physician
- Grand Rapids, MI
- NPI 1164080669
-
- Family Medicine Physician
- Holland, MI
- NPI 1083737969
-
- Adult Health Nurse Practitioner
- Holland, MI
- NPI 1457801250
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Holland, MI
Sources for this page
- 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.