Lakeland Physician Care Network

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKELAND PHYSICIAN CARE NETWORK

Practice address

1234 Napier Ave
Saint Joseph, MI 49085-2112

Phone

(269) 684-0259

Fax

(269) 684-0189

NPI assigned

May 13, 2008

Organization subpart

Yes

Parent organization

FOUR FLAGS HEALTH VENTURESAs reported in NPPES

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

Authorized official

Name

Dennis Mack

Title

V.P. Operations & Facility Manageme

Phone

(269) 983-8399

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1194992784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491200458",
            "telephone_number": "269-684-0259",
            "fax_number": "269-684-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-684-0259",
            "fax_number": "269-684-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND PHYSICIAN CARE NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUR FLAGS HEALTH VENTURES",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "V.P. OPERATIONS & FACILITY MANAGEME",
        "authorized_official_telephone_number": "269-983-8399"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.