NPIMap

Organization Active NPI

Lakeland General Surgery

  • Surgery Physician
  • Niles, MI
National Provider Identifier
1144404724
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LAKELAND GENERAL SURGERY
Practice address
60 N Saint Joseph Ave
Suite E
Niles, MI 49120-2296
Phone
(269) 684-6696
Fax
(269) 684-5286
NPI assigned
Dec 19, 2007
Last updated
Dec 19, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
LAKELAND REGIONAL HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Authorized official

Name
Dennis Mack
Title
VP Operations & Facility Mangement
Phone
(269) 983-8399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

60 N Saint Joseph Ave
Suite E
Niles, MI 49120-2296

Mailing address

60 N Saint Joseph Ave
Suite E
Niles, MI 49120-2296
Phone (269) 684-6696

National Provider Directory

National Provider Directory

Locations

60 N Saint Joseph Ave
Ste E
Niles, MI 49120
Phone (269) 684-5910

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": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1144404724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 N SAINT JOSEPH AVE",
            "address_2": "SUITE E",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202296",
            "telephone_number": "269-684-6696",
            "fax_number": "269-684-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 N SAINT JOSEPH AVE",
            "address_2": "SUITE E",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202296",
            "telephone_number": "269-684-6696",
            "fax_number": "269-684-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND GENERAL SURGERY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKELAND REGIONAL HEALTH SYSTEM",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "VP OPERATIONS & FACILITY MANGEMENT",
        "authorized_official_telephone_number": "269-983-8399"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 19, 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.

Verify at the official NPI Registry.