NPIMap

Organization Active NPI

Spectrum Health Kelsey

Doing business as Lakeview Family Medicine

  • Primary Care Clinic/Center
  • Lakeview, MI
National Provider Identifier
1356653182
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SPECTRUM HEALTH KELSEY
Doing business as
Lakeview Family Medicine
Practice address
418 Washington St
Lakeview, MI 48850-7102
Phone
(989) 352-6435
Fax
(989) 352-8451
NPI assigned
Jul 9, 2010
Last updated
Jul 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Authorized official

Name
Mr. Ryan K Johnson
Title
VP Finance
Phone
(616) 225-6428

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Rural Health Clinic/Center 261QR1300X NU

Addresses

Primary practice location

418 Washington St
Lakeview, MI 48850-7102

Mailing address

100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other names 1

  • Lakeview Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
United Mem Hosp Emerg P40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1356653182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790",
            "fax_number": "616-486-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 WASHINGTON ST",
            "city": "LAKEVIEW",
            "state": "MI",
            "postal_code": "488507102",
            "telephone_number": "989-352-6435",
            "fax_number": "989-352-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH KELSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "616-225-6428",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeview, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.