NPIMap

Organization Active NPI

Lakeland Medical Practice

  • Clinic/Center
  • Niles, MI
National Provider Identifier
1700106689
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LAKELAND MEDICAL PRACTICE
Practice address
6 Longmeadow Village Dr
Suite1
Niles, MI 49120-7810
Phone
(269) 684-6484
Fax
(269) 684-6685
NPI assigned
Jun 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Authorized official

Name
Janice Crocker
Title
Director
Phone
(269) 687-1152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

6 Longmeadow Village Dr
Suite1
Niles, MI 49120-7810

Mailing address

6 Longmeadow Village Dr
Suite1
Niles, MI 49120-7810
Phone (269) 684-6484

Other names 1

  • Lakeland Orthopaedics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakeland Medical Practices49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1700106689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LONGMEADOW VILLAGE DR",
            "address_2": "SUITE1",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207810",
            "telephone_number": "269-684-6484",
            "fax_number": "269-684-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 LONGMEADOW VILLAGE DR",
            "address_2": "SUITE1",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207810",
            "telephone_number": "269-684-6484",
            "fax_number": "269-684-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "CROCKER",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "269-687-1152"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.