NPIMap

Organization Active NPI

Lakeland Medical Practices

Doing business as Southwestern Medical Clinic - Bridgman

  • Clinic/Center
  • Bridgman, MI
National Provider Identifier
1255659744
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LAKELAND MEDICAL PRACTICES
Doing business as
Southwestern Medical Clinic - Bridgman
Practice address
9625 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone
(269) 684-0259
Fax
(269) 684-0189
NPI assigned
May 10, 2010
Last updated
Mar 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Authorized official

Name
Warren White Jr.
Title
Vice President Physician Practices
Phone
(269) 983-8304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

9625 Red Arrow Hwy
Bridgman, MI 49106-9559

Mailing address

9625 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone (269) 684-0259

Other names 1

  • Southwestern Medical Clinic - Bridgman Doing business as

National Provider Directory

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

Other organizations with this tax ID 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1255659744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9625 RED ARROW HWY",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069559",
            "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": "9625 RED ARROW HWY",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069559",
            "telephone_number": "269-684-0259",
            "fax_number": "269-684-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-10",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "VICE PRESIDENT PHYSICIAN PRACTICES",
        "authorized_official_telephone_number": "269-983-8304",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwestern Medical Clinic - Bridgman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgman, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.