Great Lakes Medical PC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GREAT LAKES MEDICAL PC

Doing business as

Gladwin Urgent Care Center

Practice address

1277 E Cedar Avenue
Suite a
Gladwin, MI 48624-7004

Phone

(989) 426-1100

Fax

(989) 426-1400

NPI assigned

Feb 7, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Richard W Macauley, MD

Title

Agent

Phone

(989) 516-4317

Specialties & licenses 2

Addresses

Other names 1

• Gladwin Urgent Care Center Doing business as

Locations

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1679845671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 E CEDAR AVE",
            "address_2": "SUITE A",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486247004",
            "telephone_number": "989-426-1100",
            "fax_number": "989-426-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 E CEDAR AVENUE",
            "address_2": "SUITE A",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486247004",
            "telephone_number": "989-426-1100",
            "fax_number": "989-426-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "MACAULEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "989-516-4317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301042308",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gladwin Urgent Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gladwin Pines Operating, LLC (Gladwin Pines Nursing and Rehabilitation Center)
• Gladwin Pines Operating, LLC (Gladwin Pines Nursing and Rehabilitation Center)
• Gladwin Urgent Care PC
• Daniel Goodin, MD
• Taylor Gorski
• Great Lakes Medical, P,C, (Gladwin Urgent Care Center)
• Raina Lee Greaves, D.C.
• Jon Guckian
• Alissa Guoan
• Debra Hamilton, PSYD, LLP

• Rural Health Clinic/Center in Gladwin, MI
• Providers in Gladwin, MI by specialty
• Rural Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.