Active NPI
Elizabeth Ann McGlothlin, M.D.
- Family Medicine Physician
- Niles, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301108540
- Practice address
- 2002 S 11TH St
Niles, MI 49120-4074 - Phone
- (269) 687-0200
- Fax
- (269) 684-0199
- NPI assigned
- Mar 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301108540 | MI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2002 S 11TH St
Niles, MI 49120-4074
Mailing address
2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124394945 | Medicaid | MI |
Other names 1
- Elizabeth Ann Weage
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Wayne State University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakeland Community Hospital Watervliet
Practice addresses (Care Compare)
2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200
Hospital & facility affiliations
- Lakeland Hospital, St Joseph
- Corewell Health Watervliet Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301108540 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Medical Practices | Current | Accepting new patients | |
| Lakeland Community Hospital Watervliet | Current | Accepting new patients | |
| Lakeland Community Hospital Watervliet | Current | Accepting new patients | |
| Lakeland Community Hospital Watervliet | Family Medicine | Current | Accepting new patients |
| Lakeland Community Hospital Watervliet | Family Medicine | Current | Accepting new patients |
| Lakeland Medical Practices | Current | Accepting new patients |
Locations
1045 E Front St
Ste A
Buchanan, MI 49107
Phone (269) 695-5540
1045 E Front St
Buchanan, MI 49107
Phone (269) 695-5540
7040 Red Arrow Hwy
Coloma, MI 49038
Phone (269) 468-4318
2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200
3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990
400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111
Interoperability endpoints
- eweage22555@lakeland.midirect.net
- emcglothlin1270783@epic00.corewelldirect.org
- https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Hartford, MI
- NPI 1023114741
Family Medicine
-
- Rural Health Clinic/Center
- Niles, MI
- NPI 1538592753
-
- Internal Medicine Physician
- Saint Joseph, MI
- NPI 1538397120
-
- Rural Health Clinic/Center
- Dowagiac, MI
- NPI 1184467607
-
- Family Medicine Physician
- Watervliet, MI
- NPI 1568644052
-
- Internal Medicine Physician
- Bridgman, MI
- NPI 1568232247
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Watervliet, MI
- NPI 1700994845
-
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1124394945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 S 11TH ST",
"city": "NILES",
"state": "MI",
"postal_code": "491204074",
"telephone_number": "269-687-0200",
"fax_number": "269-684-0199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 S 11TH ST",
"city": "NILES",
"state": "MI",
"postal_code": "491204074",
"telephone_number": "269-687-0200",
"fax_number": "269-684-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGLOTHLIN",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-26",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301108540",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124394945",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "WEAGE",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Niles, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.