NPIMap

Organization Active NPI

Midwest Internal Medicine PLLC

  • Specialist
  • Lake Havasu City, AZ
National Provider Identifier
1619174604
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MIDWEST INTERNAL MEDICINE PLLC
Practice address
1840 Mesquite Ave
Suite B
Lake Havasu City, AZ 86403-5771
Phone
(928) 453-8500
Fax
(928) 453-5556
NPI assigned
Jul 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Marty Lalande
Title
Administrator
Phone
(928) 453-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1840 Mesquite Ave
Suite B
Lake Havasu City, AZ 86403-5771

Mailing address

1840 Mesquite Ave
Suite F
Lake Havasu City, AZ 86403-5771
Phone (928) 453-8500

Other identifiers 1

IdentifierTypeStateIssuer
C02092OtherAZRAILROAD MEDICARE

Other names 1

  • Midwest MRI Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1619174604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 MESQUITE AVE",
            "address_2": "SUITE F",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035771",
            "telephone_number": "928-453-8500",
            "fax_number": "928-453-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 MESQUITE AVE",
            "address_2": "SUITE B",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035771",
            "telephone_number": "928-453-8500",
            "fax_number": "928-453-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LALANDE",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "928-453-8500"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C02092",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.