Paul James Lanzon, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601001317 Issued in MI

Practice address

3015 S State Rd
Ionia, MI 48846-9416

Phone

(616) 522-9110

Fax

(616) 522-9114

NPI assigned

May 26, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ambulatory Care Clinic of Ionia PC

  • Primary Care Clinic/Center
  • Ionia, MI
  • NPI 1548422462
  NPD

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464393600000",
    "number": "1265751424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 S STATE RD",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488468777",
            "telephone_number": "616-522-9110",
            "fax_number": "616-522-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 S STATE RD",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488469416",
            "telephone_number": "616-522-9110",
            "fax_number": "616-522-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZON",
        "first_name": "PAUL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-26",
        "last_updated": "2016-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Kookoothe, LMSW
• Madison Jean Koresh, MA, BCBA
• Janean Kriss
• Devon Marie Kruger, NP
• Kara Krupp
• Ashley Laprise, LMSW
• Lindsy Lawrence
• Mallory Christine Layman, FNP
• Ledin Therapies PLLC
• Megan Andrea Ledin, LMSW

• Physician Assistant in Ionia, MI
• Providers in Ionia, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.