Great Lakes Bay Health Centers

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GREAT LAKES BAY HEALTH CENTERS

Practice address

239 State Road
Suite a
Owosso, MI 48867-9075

Phone

(989) 729-4848

Fax

(989) 729-4849

NPI assigned

Jan 7, 2009

Organization subpart

No

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

Authorized official

Name

Lisa M Galonska

Title

Interum President

Phone

(989) 759-6464

Specialties & licenses 1

Addresses

Other names 1

• Great Lakes Bay Health Centers Shiawassee Other name

Locations

Practitioners 2

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.

• Suja Jeyasingh, MD

  • Family Medicine Physician
  • Owosso, MI
  • NPI 1730335662
  NPD (past)
• Diane C Scribner, PA-C

  • Physician Assistant
  • Owosso, MI
  • NPI 1629170394
  NPD (past)

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1548407992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071208",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 STATE ROAD",
            "address_2": "SUITE A",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679075",
            "telephone_number": "989-729-4848",
            "fax_number": "989-729-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES BAY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "GALONSKA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INTERUM PRESIDENT",
        "authorized_official_telephone_number": "989-759-6464"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Bay Health Centers Shiawassee",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mandalin Elizabeth Gray, OTRL
• Michelle Grazier
• Marko Grbesa, MS, ATC
• Great Lakes Bay Health Centers (Great Lakes Bay Health Centers Integrated Care Shiawassee)
• Great Lakes Bay Health Centers (Great Lakes Bay Health Centers Shiawassee)
• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers (Great Lakes Bay Health Centers Shiawassee Dental)
• Great Lakes Bay Health Centers (Great Lakes Bay Health Centers Shiawassee)
• Great Lakes Bay Health Centers (Great Lakes Bay Health Centers Pharmacy Shiawassee)
• Sage Green

• Federally Qualified Health Center (FQHC) in Owosso, MI
• Providers in Owosso, MI by specialty
• Federally Qualified Health Center (FQHC) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.