Individual provider Active NPI

Lauren Elisabeth Lane, D.O.

  • Internal Medicine Physician
  • Grand Haven, MI
National Provider Identifier
1225299928
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101017652 Issued in MI
Practice address
15100 Whittaker Way
Grand Haven, MI 49417-8696
Phone
(616) 935-6320
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101017652 MI Primary

Addresses

Primary practice location

15100 Whittaker Way
Grand Haven, MI 49417-8696

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other names 1

  • Lauren Elisabeth Buckles Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110805000779 MI Practitioner - Internal Medicine 1557530664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Human Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

15100 Whittaker Way
Grand Haven, MI 49417-8696
Phone (616) 772-4644

2900 Bradford St NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-6427
Phone (616) 885-5000

2902 Bradford St NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-6427
Phone (616) 486-6577

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Mary Free Bed at Home, LLC Home health agency, Grand Rapids, MI, CCN 237203
  • Harbor Hospice Hospice, Muskegon, MI, CCN 231508
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003
  • Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Jan 3, 2022 Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Jan 3, 2022 Accepting new patients
Randy S. Buckles, DO, Family Health Care, LLC PastSince Sep 16, 2019 Accepting new patients

Locations

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Interoperability endpoints

  • Direct secure messaging: lbuckles282867@epic00.corewelldirect.org
  • Direct secure messaging: laurenbuckles@bfhc.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1225299928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15100 WHITTAKER WAY",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494178696",
            "telephone_number": "616-935-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "LAUREN",
        "middle_name": "ELISABETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101017652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "BUCKLES",
            "middle_name": "ELISABETH",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.