NPIMap

Organization Active NPI

Lakeland Medical Practices

Doing business as Lakeland Neurology

  • Neurology Physician
  • Saint Joseph, MI
National Provider Identifier
1174038392
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
LAKELAND MEDICAL PRACTICES
Doing business as
Lakeland Neurology
Practice address
3950 Hollywood Rd Ste 230
Saint Joseph, MI 49085-9158
Phone
(269) 985-0000
Fax
(269) 985-0360
NPI assigned
Dec 11, 2017
Last updated
Dec 11, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
LAKELAND MEDICAL PRACTICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Authorized official

Name
Morgan Vincent
Title
Medical Staff Coordinator
Phone
(269) 983-8282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

3950 Hollywood Rd Ste 230
Saint Joseph, MI 49085-9158

Mailing address

3950 Hollywood Rd Ste 230
Saint Joseph, MI 49085-9158
Phone (269) 985-0000

Other names 1

  • Lakeland Neurology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakeland Medical Practices49 organizations share this tax ID, including this one
Part of
Lakeland Medical Practices

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

Locations

3950 Hollywood Rd
Ste 230
Saint Joseph, MI 49085
Phone (269) 985-0000

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1174038392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 230",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859158",
            "telephone_number": "269-985-0000",
            "fax_number": "269-985-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 230",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859158",
            "telephone_number": "269-985-0000",
            "fax_number": "269-985-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKELAND MEDICAL PRACTICES",
        "enumeration_date": "2017-12-11",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "MEDICAL STAFF COORDINATOR",
        "authorized_official_telephone_number": "269-983-8282"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.