Lakeshore Concierge Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LAKESHORE CONCIERGE MEDICINE PLLC

Practice address

1450 Farr Rd
Norton Shores, MI 49444-9770

Phone

(231) 638-1414

NPI assigned

Feb 17, 2021

Last updated

Feb 17, 2021By 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. Todd W Rexford, MDNPI 1740284330

Title

Owner

Phone

(231) 638-1414

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23527/brand/1/csg/1/fhir/r4

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.

• Todd W Rexford, MD

  • Family Medicine Physician
  • Norton Shores, MI
  • NPI 1740284330
  Medicare reassignment NPD Authorized official
• Anna Liese Kooi

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1255999751

  MI

  Medicare reassignment NPD

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1619560026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 FOREST PARK RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494414638",
            "telephone_number": "231-638-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 FARR RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449770",
            "telephone_number": "231-638-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE CONCIERGE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "REXFORD",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-638-1414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Edward Kursch, M.D.
• Jeremy Ladronka, M. ED
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• Lakes OBGYN Specialist (Trinity Health Medical Group Obstetrics & Gynecology - Lake Village)
• Lakeshore Derm & Laser Center PLC
• Lakeshore Integrative Mental Health Services, LLC
• Lakeshore Professional Eyecare PC (Lakeshore Eyecare)
• Laketown Family Dental, PLLC (Laketown Family Dental)
• Ivan R Landan, M.D.

• Family Medicine Physician in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.