NPIMap

Organization Active NPI

Lakeland Medical Practices

  • Family Medicine Physician
  • Berrien Springs, MI
National Provider Identifier
1285270249
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKELAND MEDICAL PRACTICES
Practice address
9045 Old US 31
Suite a
Berrien Springs, MI 49103
Phone
(269) 473-2222
Fax
(269) 473-6880
NPI assigned
Nov 25, 2019
Organization subpart
Yes
Parent organization
LAKELAND MEDICAL PRACTICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Authorized official

Name
Morgan Vincent
Title
Medical Staff Coordinator
Phone
(269) 983-8282

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9045 Old US 31
Suite a
Berrien Springs, MI 49103

Mailing address

9045 Old US 31
Suite a
Berrien Springs, MI 49103
Phone (269) 473-2222

Other names 1

  • University Medical Specialties Doing business as

National Provider Directory

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

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": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1285270249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 OLD US 31",
            "address_2": "SUITE A",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "49103",
            "telephone_number": "269-473-2222",
            "fax_number": "269-473-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 OLD US 31",
            "address_2": "SUITE A",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "49103",
            "telephone_number": "269-473-2222",
            "fax_number": "269-473-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKELAND MEDICAL PRACTICES",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "MEDICAL STAFF COORDINATOR",
        "authorized_official_telephone_number": "269-983-8282"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Medical Specialties",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berrien Springs, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.