NPIMap

Organization Active NPI

Lakeland Medical Practices

Doing business as Lakeland Cancer Specialist

  • Oncology Clinic/Center
  • Saint Joseph, MI
National Provider Identifier
1225321045
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Clinic/CenterTaxonomy code 261QX0200X
License
4301085395 Issued in MI
Legal business name
LAKELAND MEDICAL PRACTICES
Doing business as
Lakeland Cancer Specialist
Practice address
3950 Hollywood Rd
Suite 240
Saint Joseph, MI 49085-9159
Phone
(269) 428-4411
Fax
(269) 428-4422
NPI assigned
May 26, 2011
Last updated
Jun 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Authorized official

Name
Janice Crocker
Title
Director Practice Operations
Phone
(269) 687-1152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Clinic/Center 261QX0200X 4301085395 MI Primary

Addresses

Primary practice location

3950 Hollywood Rd
Suite 240
Saint Joseph, MI 49085-9159

Mailing address

3900 Hollywood Rd
Saint Joseph, MI 49085-9149
Phone (269) 428-4411

Other names 1

  • Lakeland Cancer Specialist Doing business as

National Provider Directory

National Provider Directory
Tax ID family
High Desert Family Foot Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1225321045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859149",
            "telephone_number": "269-428-4411",
            "fax_number": "269-428-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD",
            "address_2": "SUITE 240",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-428-4411",
            "fax_number": "269-428-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "DIRECTOR PRACTICE OPERATIONS",
        "authorized_official_telephone_number": "269-687-1152"
    },
    "taxonomies": [
        {
            "code": "261QX0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology",
            "state": "MI",
            "license": "4301085395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Cancer Specialist",
            "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 Jun 27, 2011; 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.