NPIMap

Organization Active NPI

McLaren Greater Lansing

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lansing, MI
National Provider Identifier
1124221478
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
MCLAREN GREATER LANSING
Practice address
840 E Mount Hope Ave
Suite 203
Lansing, MI 48910
Phone
(517) 487-2273
Fax
(517) 487-2268
NPI assigned
Jun 6, 2007
Last updated
Aug 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Authorized official

Name
Mr. Dale Thompson
Title
Cfo
Phone
(517) 975-7555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU Primary

Addresses

Primary practice location

840 E Mount Hope Ave
Suite 203
Lansing, MI 48910

Mailing address

840 E Mount Hope Ave
Suite 203
Lansing, MI 48910-3293
Phone (517) 487-2273

Other identifiers 1

IdentifierTypeStateIssuer
330C313780OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031217000526 MI Part B Supplier - Clinic/Group Practice 7214833466 Receives reassigned benefits from 100 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Okemos, MI; Lansing, MI; Grand Ledge, MI

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Locations

840 E Mount Hope Ave
Ste 203
Lansing, MI 48910
Phone (517) 487-2273

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1124221478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E MOUNT HOPE AVE",
            "address_2": "SUITE 203",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489103293",
            "telephone_number": "517-487-2273",
            "fax_number": "517-487-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E MOUNT HOPE AVE",
            "address_2": "SUITE 203",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48910",
            "telephone_number": "517-487-2273",
            "fax_number": "517-487-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN GREATER LANSING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "517-975-7555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "330C313780",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.