NPIMap

Organization Active NPI

Lakeland Medical Practices

  • Clinic/Center
  • Niles, MI
National Provider Identifier
1376863407
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LAKELAND MEDICAL PRACTICES
Practice address
42 N Saint Joseph Ave
Suite 101
Niles, MI 49120-2208
Phone
(269) 687-4673
Fax
(269) 687-1798
NPI assigned
Jun 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Janice Crocker
Title
Director
Phone
(269) 687-1152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

42 N Saint Joseph Ave
Suite 101
Niles, MI 49120-2208

Mailing address

6416 Deans Hill Rd
Berrien Center, MI 49102-9750
Phone (269) 687-4673

Other names 1

  • Lakeland Comprehensive Weight Loss Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakeland Medical Practices49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Locations

6416 Deans Hill Rd
Berrien Ctr, MI 49102
Phone (269) 471-7741

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1376863407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 DEANS HILL RD",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491029750",
            "telephone_number": "269-687-4673",
            "fax_number": "269-687-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 N SAINT JOSEPH AVE",
            "address_2": "SUITE 101",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202208",
            "telephone_number": "269-687-4673",
            "fax_number": "269-687-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "269-687-1152"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Comprehensive Weight Loss Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.