Great Lakes Pediatrics

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

4301073962 Issued in MI

Legal business name

GREAT LAKES PEDIATRICS

Practice address

26000 Hoover Rd
103
Warren, MI 48089-1167

Phone

(586) 427-1351

NPI assigned

Feb 21, 2008

Last updated

Feb 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sundus Rummani-Askar, M.D.NPI 1669499547

Title

President

Phone

(586) 427-1351

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sundus Fathalla Rummani-Askar, MD

  • Pediatrics Physician
  • Warren, MI
  • NPI 1669499547
  NPD (past) Authorized official
• Maan A Askar, MD

  • Family Medicine Physician
  • Warren, MI
  • NPI 1053321117
  NPD (past)
• Lisa Yacoub, N.P-C

  • Family Nurse Practitioner
  • Warren, MI
  • NPI 1588931059
  NPD (past)

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1417126715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26000 HOOVER RD",
            "address_2": "103",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480891167",
            "telephone_number": "586-427-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26000 HOOVER RD",
            "address_2": "103",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480891167",
            "telephone_number": "586-427-1351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "RUMMANI-ASKAR",
        "authorized_official_first_name": "SUNDUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-427-1351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301073962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4435267",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Great Lakes Home Medical Equipment, Inc.
• Great Lakes Medical Center PC
• Great Lakes Medical Pharmacy LLC (All American Medical Pharmacy)
• Great Lakes Medical Supply LLC (BrightSky)
• Great Lakes MRI of Michigan LLC
• Great Lakes Pharmacies I Inc (Village Pharmacy)
• Great Lakes Pharmacies I Inc (Village Pharmacy)
• Great Lakes Physical Therapy and Rehabilitation LLC
• Great Lakes Seniors PC
• Greater Care Pharmacy LLC

• Pediatric Adolescent Medicine Physician in Warren, MI
• Providers in Warren, MI by specialty
• Pediatric Adolescent Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.