Lakeland Specialty Hospital at Berrien Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

113010 Issued in MI

Legal business name

LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER

Practice address

6418 Deans Hill Rd
Berrien Center, MI 49102-9750

Phone

(269) 473-3003

Fax

(269) 473-3010

NPI assigned

Jul 17, 2006

Last updated

Jun 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tim Calhoun

Title

Cfo/VP of Finance

Phone

(269) 983-8398

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1285651760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490850800",
            "telephone_number": "269-428-2574",
            "fax_number": "269-428-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 DEANS HILL RD",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491029750",
            "telephone_number": "269-473-3003",
            "fax_number": "269-473-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND SPECIALTY HOSPITAL AT BERRIEN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "CALHOUN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CFO/VP OF FINANCE",
        "authorized_official_telephone_number": "269-983-8398",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "113010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "S9516",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4164932",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tricia Newland Johnson, L.M.S.W
• Thomas Johnston
• Karen Joy Knauss, RD
• Lakeland Pharmacy Berrien
• Lakeland Specialty Hospital
• Lakeland Specialty Hospital at Berrien Center
• Laura Marie Landrey, R.D.
• Leslie Louise Liles
• Patricia Lisowski, CCAR
• Ryan Allen Lutin

• Skilled Nursing Facility in Berrien Center, MI
• Providers in Berrien Center, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.