Great Lakes Medical Services LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

GREAT LAKES MEDICAL SERVICES LLC

Practice address

1021 Sandusky St
Ste C
Perrysburg, OH 43551

Phone

(419) 872-5343

Fax

(419) 872-7465

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Evan Kyle Brueler

Title

President

Phone

(419) 872-5343

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Great Lakes Medical Services LLC

  • Urgent Care Clinic/Center
  • Perrysburg, OH
  • NPI 1184705121

  O20050525000695

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd Aaron Meredith, M.D.

  • General Practice Physician
  • Oregon, OH
  • NPI 1841283272
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326152091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 SANDUSKY ST",
            "address_2": "STE C",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "43551",
            "telephone_number": "419-872-5343",
            "fax_number": "419-872-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 SANDUSKY ST",
            "address_2": "STE C",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "43551",
            "telephone_number": "419-872-5343",
            "fax_number": "419-872-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUELER",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-872-5343"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Graham, LISW
• Nicholas John Graham
• Caleb Graveldinger
• Great Lakes Employment Services LTD
• Great Lakes Medical Services LLC
• Great Lakes Medical Services LLC
• Great Lakes Nursing LLC
• Christina Michelle Green, MA
• Henry B Green, DPM
• Rimple Grewal, DMD

• Urgent Care Clinic/Center in Perrysburg, OH
• Providers in Perrysburg, OH by specialty
• Urgent Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.