Active NPI
Lake Country Health Alliance
- Pediatrics Physician
- Sturgis, MI
National Provider Identifier
1134310022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- LAKE COUNTRY HEALTH ALLIANCE
- Practice address
- 17 Vinewood Ave
Sturgis, MI 49091-2375 - Phone
- (269) 651-4708
- NPI assigned
- Aug 6, 2007
- Organization subpart
- Yes
- Parent organization
- LAKE COUNTRY UROLOGY CLINIC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mariano Orca, MD
- Title
- MD
- Phone
- (269) 651-4708
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
17 Vinewood Ave
Sturgis, MI 49091-2375
Mailing address
17 Vinewood Ave
Sturgis, MI 49091-2375
Phone (269) 651-4708
Other names 1
- LAKE COUNTRY UROLOGY CLINIC
National Provider Directory
National Provider Directory- Tax ID family
- Lake Country Urology Clinic PLLC
- Part of
- Lake Country Urology Clinic PLLC
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Urology Physician
- Coldwater, MI
- NPI 1154453926
-
- Urology Physician
- Dowagiac, MI
- NPI 1528190303
-
- Urology Physician
- Three Rivers, MI
- NPI 1952433732
Locations
17 Vinewood Ave
Sturgis, MI 49091
Phone (269) 651-4708
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1186358400000",
"number": "1134310022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 VINEWOOD AVE",
"city": "STURGIS",
"state": "MI",
"postal_code": "490912375",
"telephone_number": "269-651-4708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 VINEWOOD AVE",
"city": "STURGIS",
"state": "MI",
"postal_code": "490912375",
"telephone_number": "269-651-4708"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKE COUNTRY HEALTH ALLIANCE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LAKE COUNTRY UROLOGY CLINIC",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A",
"authorized_official_last_name": "ORCA",
"authorized_official_first_name": "MARIANO",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "269-651-4708",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "LAKE COUNTRY UROLOGY CLINIC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Sturgis, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.