Great Lakes Prosthetics and Busch Daniel J Member

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

GREAT LAKES PROSTHETICS AND BUSCH DANIEL J MEMBER

Practice address

5315 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8634

Phone

(734) 528-5200

Fax

(734) 528-5260

NPI assigned

Feb 28, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Christopher James Fairman, CPO

Title

Co-Owner

Phone

(734) 528-5200

Specialties & licenses 1

Addresses

Other names 1

• Great Lakes Prosthetics and Orthotics LLC Other name

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1316245343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DR",
            "address_2": "SUITE 104",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978634",
            "telephone_number": "734-528-5200",
            "fax_number": "734-528-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DR",
            "address_2": "SUITE 104",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978634",
            "telephone_number": "734-528-5200",
            "fax_number": "734-528-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PROSTHETICS AND BUSCH DANIEL J MEMBER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-28",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "FAIRMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "734-528-5200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Prosthetics and Orthotics LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Colleen Graves, PA
• Ciara Gravlin
• Brooklyn Gray
• Lakeya Gray
• Great Lakes Prosthetics & Orthotics, Inc
• Great Lakes Visiting Physicians PC
• Anthony S. Grech, M.D.
• Green Kleen LLC
• Chace Green
• Dayna Marie Green, CRNA

• Prosthetic/Orthotic Supplier in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; 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.