NPIMap

Organization Active NPI

Mi Street Orthopedic Specialists PC

  • Orthopaedic Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1497860795
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MI STREET ORTHOPEDIC SPECIALISTS PC
Practice address
1300 Michigan St NE
Suite 200
Grand Rapids, MI 49503-2026
Phone
(616) 774-9515
Fax
(616) 774-7116
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name
Lori E Lumley
Title
Practice Manager
Phone
(616) 774-9515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1300 Michigan St NE
Suite 200
Grand Rapids, MI 49503-2026

Mailing address

1300 Michigan St NE
Suite 200
Grand Rapids, MI 49503-2026
Phone (616) 774-9515

Other names 1

  • Bereza & Lovell Orthopedics, P.C. Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1497860795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MICHIGAN ST NE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032026",
            "telephone_number": "616-774-9515",
            "fax_number": "616-774-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICHIGAN ST NE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032026",
            "telephone_number": "616-774-9515",
            "fax_number": "616-774-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI STREET ORTHOPEDIC SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "LUMLEY",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "616-774-9515"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bereza & Lovell Orthopedics, P.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.