NPIMap

Organization Active NPI

Lakeland Medical Practices

Doing business as Stonegate Plactic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Saint Joseph, MI
National Provider Identifier
1417324393
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
4301056980 Issued in MI
Legal business name
LAKELAND MEDICAL PRACTICES
Doing business as
Stonegate Plactic Surgery
Practice address
3901 Stonegate Park
Suite 300
Saint Joseph, MI 49085-9137
Phone
(269) 556-6000
Fax
(269) 556-6020
NPI assigned
Aug 27, 2015
Last updated
Aug 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Authorized official

Name
Warren White Jr.
Title
Vice President Physician Services
Phone
(269) 983-8304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 4301056980 MI Primary

Addresses

Primary practice location

3901 Stonegate Park
Suite 300
Saint Joseph, MI 49085-9137

Mailing address

3901 Stonegate Park
Suite 300
Saint Joseph, MI 49085-9137
Phone (269) 556-6000

Other names 1

  • Stonegate Plactic Surgery 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

3901 Stonegate Park
Ste 300
Saint Joseph, MI 49085
Phone (269) 408-4265

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1417324393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 STONEGATE PARK",
            "address_2": "SUITE 300",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859137",
            "telephone_number": "269-556-6000",
            "fax_number": "269-556-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 STONEGATE PARK",
            "address_2": "SUITE 300",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859137",
            "telephone_number": "269-556-6000",
            "fax_number": "269-556-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "VICE PRESIDENT PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "269-983-8304",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MI",
            "license": "4301056980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonegate Plactic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 27, 2015; 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.