NPIMap

Organization Active NPI

McLaren Lapeer Region

  • Certified Registered Nurse Anesthetist
  • Lapeer, MI
National Provider Identifier
1124151147
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MCLAREN LAPEER REGION
Practice address
1375 N Main St
Lapeer, MI 48446-1350
Phone
(810) 667-5500
NPI assigned
Mar 13, 2007
Last updated
Jun 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Authorized official

Name
Fred Korte
Title
VP/Cfo
Phone
(810) 342-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X MI Primary

Addresses

Primary practice location

1375 N Main St
Lapeer, MI 48446-1350

Mailing address

1375 N Main St
Lapeer, MI 48446-1350
Phone (810) 667-5500

Other identifiers 1

IdentifierTypeStateIssuer
430D460800OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050730000017 MI Part B Supplier - Clinic/Group Practice 8123000544 Receives reassigned benefits from 64 practitioners
3 other NPIs on this enrollment
Practice locations: Metamora, MI; North Branch, MI; Lapeer, MI

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

7115 Cade Rd
Brown City, MI 48416
Phone (810) 346-2757

1181 S Lapeer Rd
Lapeer, MI 48446
Phone (810) 667-7040

Practitioners & affiliated clinicians

Practitioners 64

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.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1124151147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461350",
            "telephone_number": "810-667-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461350",
            "telephone_number": "810-667-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN LAPEER REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "KORTE",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "810-342-2000"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "430D460800",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.