NPIMap

Organization Active NPI

John Leclaire M.D., P.L.C.

  • Specialist
  • Muskegon, MI
National Provider Identifier
1639123771
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
JL038974 Issued in MI
Legal business name
JOHN LECLAIRE M.D., P.L.C.
Practice address
172 E Forest Ave
Muskegon, MI 49442-5541
Phone
(231) 728-3749
Fax
(231) 722-4652
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John Leclaire, M.D.
Title
Owner
Phone
(231) 728-3749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X JL038974 MI Primary

Addresses

Primary practice location

172 E Forest Ave
Muskegon, MI 49442-5541

Mailing address

PO Box 86
Muskegon, MI 49443-0086
Phone (231) 780-6086

Other identifiers 1

IdentifierTypeStateIssuer
1375648MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639123771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494430086",
            "telephone_number": "231-780-6086",
            "fax_number": "231-780-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 E FOREST AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425541",
            "telephone_number": "231-728-3749",
            "fax_number": "231-722-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN LECLAIRE M.D., P.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LECLAIRE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-728-3749",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "JL038974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1375648",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • 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.