Active NPI
Region IV Area Agency on Aging, Inc
- Case Management Agency
- Saint Joseph, MI
National Provider Identifier
1366524985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Legal business name
- REGION IV AREA AGENCY ON AGING, INC
- Practice address
- 2900 Lakeview Ave
Saint Joseph, MI 49085-2379 - Phone
- (269) 983-0177
- NPI assigned
- Oct 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christine Vanlandingham
- Title
- Ceo
- Phone
- (269) 983-0177
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Primary | ||
| Primary Care Clinic/Center | 261QP2300X |
Addresses
Primary practice location
2900 Lakeview Ave
Saint Joseph, MI 49085-2379
Mailing address
2900 Lakeview Ave
Saint Joseph, MI 49085-2379
Phone (269) 983-0177
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4508944 | Medicaid | MI | |
| 4509342 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160908000217 | MI | Part B Supplier - Clinic/Group Practice | 7315233905 |
Receives reassigned benefits from 7 practitioners Practice locations: Saint Joseph, MI |
National Provider Directory
National Provider Directory- Tax ID family
- Region IV Area Agncy Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Saint Joseph, MI
- NPI 1003050188
-
- Gerontology Nurse Practitioner
- Saint Joseph, MI
- NPI 1265255327
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gerontology Nurse Practitioner
- Mishawaka, IN
- NPI 1851060412
MI, Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689724800000",
"number": "1366524985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 LAKEVIEW AVE",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490852379",
"telephone_number": "269-983-0177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 LAKEVIEW AVE",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490852379",
"telephone_number": "269-983-0177"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REGION IV AREA AGENCY ON AGING, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-20",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A",
"authorized_official_last_name": "VANLANDINGHAM",
"authorized_official_first_name": "CHRISTINE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "269-983-0177"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4508944",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4509342",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.