NPIMap

Organization Active NPI

Greater Lakes Ambulatory Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Clinton Township, MI
National Provider Identifier
1679717466
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
506836 Issued in MI
Legal business name
GREATER LAKES AMBULATORY SURGICAL CENTER, LLC
Practice address
16100 19 Mile Rd
Suite 100
Clinton Township, MI 48038-1148
Phone
(586) 286-0000
Fax
(586) 286-0005
NPI assigned
Apr 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Authorized official

Name
Allison Anita Brynaert, RN, BSN, RNFA
Title
Administrator/Director
Phone
(586) 286-0000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 506836 MI Primary

Addresses

Primary practice location

16100 19 Mile Rd
Suite 100
Clinton Township, MI 48038-1148

Mailing address

16100 19 Mile Rd
Suite 100
Clinton Township, MI 48038-1148
Phone (586) 286-0000

Other names 1

  • Greater Lakes Ambulatory Surgery Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1679717466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 19 MILE RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381148",
            "telephone_number": "586-286-0000",
            "fax_number": "586-286-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 19 MILE RD",
            "address_2": "SUITE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381148",
            "telephone_number": "586-286-0000",
            "fax_number": "586-286-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LAKES AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "BRYNAERT",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "ANITA",
        "authorized_official_title_or_position": "ADMINISTRATOR/DIRECTOR",
        "authorized_official_telephone_number": "586-286-0000",
        "authorized_official_credential": "RN, BSN, RNFA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "506836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Lakes Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.