NPIMap

Organization Active NPI

Lakes Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • West Bloomfield, MI
National Provider Identifier
1699786624
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LAKES URGENT CARE, INC.
Practice address
2300 Haggerty Rd
Suite 1010
West Bloomfield, MI 48323-2184
Phone
(248) 926-9111
Fax
(248) 926-9112
NPI assigned
Aug 11, 2006
Last updated
Sep 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Authorized official

Name
Dr. Sanford J Vieder, D.O.NPI 1952335028
Title
Medical Director
Phone
(248) 926-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

2300 Haggerty Rd
Suite 1010
West Bloomfield, MI 48323-2184

Mailing address

PO Box 251956
West Bloomfield, MI 48325-1956
Phone (248) 926-9111

Other identifiers 3

IdentifierTypeStateIssuer
139387OtherCARE CHOICES
0N92240OtherHEALTH ALLIANCE PLAN
700F327420OtherBCBS OF MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040714000662 MI Part B Supplier - Clinic/Group Practice 1052390127 Receives reassigned benefits from 7 practitioners
Practice locations: Livonia, MI; West Bloomfield, MI

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1699786624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251956",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483251956",
            "telephone_number": "248-926-9111",
            "fax_number": "248-926-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD",
            "address_2": "SUITE 1010",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232184",
            "telephone_number": "248-926-9111",
            "fax_number": "248-926-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES URGENT CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "VIEDER",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-926-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "139387",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "0N92240",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "700F327420",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.