Southwestern Medical Clinic Oc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SOUTHWESTERN MEDICAL CLINIC OC

Practice address

300 W Ferry St
Berrien Springs, MI 49103-1109

Phone

(269) 473-2387

Fax

(269) 473-2698

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Diane Baker

Title

Lab Director

Phone

(269) 473-2387

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1336334408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W FERRY ST",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031109",
            "telephone_number": "269-473-2387",
            "fax_number": "269-473-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W FERRY ST",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031109",
            "telephone_number": "269-473-2387",
            "fax_number": "269-473-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN MEDICAL CLINIC OC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "269-473-2387"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4399652",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harold B Smith, PYS.D.
• Kourtney Renee Smith, DPT, PT
• Sarah K. Smith, LMT
• Chloe M Son, D.M.D.
• Linda Song, NP-C
• Spinalhealth & Healing
• Angela St. Hillaire, PHD, LP, LPC
• Shelley Stevens
• Denise Ann Stoddard, PH.D.
• Stowe Chiropractic Life Center (Advanced Chiropractic)

• Clinical Medical Laboratory in Berrien Springs, MI
• Providers in Berrien Springs, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.