NPIMap

Organization Active NPI

Lakeland Medical Practices

  • Endocrinology, Diabetes & Metabolism Physician
  • Saint Joseph, MI
National Provider Identifier
1508102633
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301088693 Issued in MI
Legal business name
LAKELAND MEDICAL PRACTICES
Practice address
3950 Hollywood Rd
Suite 284
Saint Joseph, MI 49085-9159
Phone
(269) 408-1600
Fax
(269) 408-1602
NPI assigned
Dec 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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 Practices
Phone
(269) 921-4315

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 4301088693 MI Primary
Clinic/Center 261Q00000X MI

Addresses

Primary practice location

3950 Hollywood Rd
Suite 284
Saint Joseph, MI 49085-9159

Mailing address

3950 Hollywood Rd
Suite 284
Saint Joseph, MI 49085-9159
Phone (269) 408-1600

Other names 1

  • Lakeland Edocrinology & Diabetes 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

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1508102633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD",
            "address_2": "SUITE 284",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-408-1600",
            "fax_number": "269-408-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD",
            "address_2": "SUITE 284",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-408-1600",
            "fax_number": "269-408-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "VICE PRESIDENT PHYSICIAN PRACTICES",
        "authorized_official_telephone_number": "269-921-4315",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301088693",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Edocrinology & Diabetes",
            "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 Jan 2, 2013; 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.