Grand Lake Sleep Center

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

GRAND LAKE SLEEP CENTER

Practice address

1040 Hager St
Saint Marys, OH 45885-2421

Phone

(419) 394-9992

Fax

(419) 394-9629

NPI assigned

Sep 28, 2006

Last updated

Aug 22, 2020By 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. Sarat Babu Kuchipudi, M.D.

Title

Medical Director

Phone

(419) 394-9992

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578654950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 HAGER ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852421",
            "telephone_number": "419-394-9992",
            "fax_number": "419-394-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 HAGER ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852421",
            "telephone_number": "419-394-9992",
            "fax_number": "419-394-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND LAKE SLEEP CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUCHIPUDI",
        "authorized_official_first_name": "SARAT",
        "authorized_official_middle_name": "BABU",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "419-394-9992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Cristina Gonzalez, MD
• Garnett Rana Goodwin
• Kristen Gower
• Grand Lake Operations (Vancrest of St Marys)
• Grand Lake Operations, LLC
• Green Palms Health & Rehab Center of St. Marys, LLC
• Amber Ann Griffis, LPN
• Janelle L Hardesty, LPTA
• William F Harr III, CRNA
• Rebecca R Hawkey

• Sleep Disorder Diagnostic Clinic/Center in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Sleep Disorder Diagnostic Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.