Active NPI
McLaren Lapeer Region
- Certified Registered Nurse Anesthetist
- Lapeer, MI
National Provider Identifier
1124151147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- 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
- 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
- Fred Korte
- Title
- VP/Cfo
- Phone
- (810) 342-2000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430D460800 | Other | MI | BCBSM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryPractitioners & affiliated clinicians
Practitioners 64
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Health Nurse Practitioner
- Bloomfield Hills, MI
- NPI 1295709103
MI
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": "193400000X SINGLE SPECIALTY 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.