Active NPI
Edward David Lanigan, M.D.
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Niles, MI
National Provider Identifier
1255444907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- License
- 4301035365
- Practice address
- 42 N Saint Joseph Ave
Suite 103
Niles, MI 49120-2203 - Phone
- (269) 683-8070
- Fax
- (269) 683-8660
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 2083P0011X | 4301035365 | MI | Primary |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 4301035365 | MI |
Addresses
Primary practice location
42 N Saint Joseph Ave
Suite 103
Niles, MI 49120-2203
Mailing address
42 N Saint Joseph Ave
Suite 103
Niles, MI 49120-2203
Phone (269) 683-8070
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4354697 | Medicaid | MI | |
| 1255444907 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490572800000",
"number": "1255444907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 N SAINT JOSEPH AVE",
"address_2": "SUITE 103",
"city": "NILES",
"state": "MI",
"postal_code": "491202203",
"telephone_number": "269-683-8070",
"fax_number": "269-683-8660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 N SAINT JOSEPH AVE",
"address_2": "SUITE 103",
"city": "NILES",
"state": "MI",
"postal_code": "491202203",
"telephone_number": "269-683-8070",
"fax_number": "269-683-8660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANIGAN",
"first_name": "EDWARD",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2017-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0011X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
"state": "MI",
"license": "4301035365",
"primary": true
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "MI",
"license": "4301035365",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4354697",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1255444907",
"state": "MI"
}
],
"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 Mar 27, 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.