NPIMap

Organization Active NPI

Great Lakes Pain & Rehab, PC

  • Family Medicine Physician
  • Flint, MI
National Provider Identifier
1326314972
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GREAT LAKES PAIN & REHAB, PC
Practice address
G3237 Beecher Rd
Suite B
Flint, MI 48532-3695
Phone
(810) 733-0600
NPI assigned
Mar 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Mr. Todd Sussman
Title
Worker
Phone
(810) 733-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MI Primary

Addresses

Primary practice location

G3237 Beecher Rd
Suite B
Flint, MI 48532-3695

Mailing address

G3237 Beecher Rd
Suite B
Flint, MI 48532-3695

National Provider Directory

National Provider Directory

Locations

G3237 Beecher Rd
Ste B
Flint, MI 48532
Phone (810) 733-0600

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1326314972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G3237 BEECHER RD",
            "address_2": "SUITE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3237 BEECHER RD",
            "address_2": "SUITE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323695",
            "telephone_number": "810-733-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PAIN & REHAB, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "SUSSMAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "WORKER",
        "authorized_official_telephone_number": "810-733-0600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.