LDK III Holdings, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101010860 Issued in MI

Legal business name

LDK III HOLDINGS, LLC

Practice address

451 Hidden Meadows Dr
Suite 120
Hillsdale, MI 49242-9812

Phone

(517) 437-0010

Fax

(517) 437-0319

NPI assigned

Jul 10, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence Dustin Kimball III, D.O.NPI 1346248937

Title

Physician

Phone

(517) 437-0010

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 6

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.

• Lawrence Dustin Kimball III, DO

  • Family Medicine Physician
  • Hillsdale, MI
  • NPI 1346248937
  Medicare reassignment NPD Authorized official
• Erin Elizabeth Blanchard, PA-C

  • Physician Assistant
  • Jackson, MI
  • NPI 1639504517
  Medicare reassignment
• Karen Lindower, DO

  • Family Medicine Physician
  • Hillsdale, MI
  • NPI 1033117627
  NPD
• Leslie Bennett-Granata, MD

  • Family Medicine Physician
  • Hillsdale, MI
  • NPI 1093713679
  NPD (past)
• Debra A Lusty, DO

  • Family Medicine Physician
  • Hillsdale, MI
  • NPI 1477551067
  NPD (past)
• Ravi David Yarid, D.O.

  • Family Medicine Physician
  • Suwanee, GA
  • NPI 1902005762
  NPD (past)

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1073929089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HIDDEN MEADOWS DR",
            "address_2": "SUITE 120",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429812",
            "telephone_number": "517-437-0010",
            "fax_number": "517-437-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HIDDEN MEADOWS DR",
            "address_2": "SUITE 120",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429812",
            "telephone_number": "517-437-0010",
            "fax_number": "517-437-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDK III HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "DUSTIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "517-437-0010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101010860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody J Kryfka
• Kwasi Opuni Boakye, M.D., P.C.
• Edwin Kwon, D.D.S.
• Larissa Laidler
• Kayla R Lange
• Craig Thomas Lee, PHARMD, R.PH.
• Kendall J Lee, DDS
• Stacy Janelle Lee, FNP
• Zachary James Lee, DDS
• Arla Jean Leininger, BA

• Family Medicine Physician in Hillsdale, MI
• Providers in Hillsdale, 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 Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.