NPIMap

Organization Active NPI

Spectrum Health Kelsey

Doing business as Lakeview Youth Clinic

  • General Practice Physician
  • Lakeview, MI
National Provider Identifier
1730466822
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SPECTRUM HEALTH KELSEY
Doing business as
Lakeview Youth Clinic
Practice address
420 S Lincoln St
Lakeview, MI 48850-8500
Phone
(989) 352-1800
NPI assigned
Nov 3, 2011
Last updated
Nov 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
David J Oehring
Title
Vice President Finance
Phone
(616) 225-6411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

420 S Lincoln St
Lakeview, MI 48850-8500

Mailing address

418 Washington St
Lakeview, MI 48850-9806
Phone (989) 352-6435

Other names 1

  • Lakeview Youth Clinic 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": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1730466822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 WASHINGTON ST",
            "city": "LAKEVIEW",
            "state": "MI",
            "postal_code": "488509806",
            "telephone_number": "989-352-6435",
            "fax_number": "989-352-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S LINCOLN ST",
            "city": "LAKEVIEW",
            "state": "MI",
            "postal_code": "488508500",
            "telephone_number": "989-352-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH KELSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "OEHRING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "616-225-6411"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Youth Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeview, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.