NPIMap

Organization Active NPI

Michigan State University

  • Clinical Medical Laboratory
  • East Lansing, MI
National Provider Identifier
1295978054
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
23D0650872 Issued in MI
Legal business name
MICHIGAN STATE UNIVERSITY
Practice address
1355 Bogue St RM B228
East Lansing, MI 48824-6207
Phone
(517) 355-4616
Fax
(517) 353-5436
NPI assigned
Apr 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Authorized official

Name
Lisa Rucker
Title
Enrollment & Patient Accts Manager
Phone
(517) 884-2976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 23D0650872 MI Primary

Addresses

Primary practice location

1355 Bogue St RM B228
East Lansing, MI 48824-6207

Mailing address

1355 Bogue Street
Room B228
East Lansing, MI 48824-6239
Phone (517) 355-4616

National Provider Directory

National Provider Directory

Locations

1355 Bogue St
Rm B228
East Lansing, MI 48824
Phone (517) 355-4616

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522886400000",
    "number": "1295978054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 BOGUE STREET",
            "address_2": "ROOM B228",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488246239",
            "telephone_number": "517-355-4616",
            "fax_number": "517-353-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 BOGUE ST RM B228",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488246207",
            "telephone_number": "517-355-4616",
            "fax_number": "517-353-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2018-04-05",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ENROLLMENT & PATIENT ACCTS MANAGER",
        "authorized_official_telephone_number": "517-884-2976"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "23D0650872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.