Organization Active NPI

Great Lakes Orthopaedics

  • Orthopaedic Surgery Physician
  • Garden City, MI
National Provider Identifier
1740375518
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GREAT LAKES ORTHOPAEDICS
Practice address
6255 Inkster Rd
Ste 103
Garden City, MI 48135-2577
Phone
(734) 422-8400
NPI assigned
Oct 4, 2006
Last updated
Mar 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Authorized official

Name
Jeffrey E Lawley, D.O.NPI 1952372104
Title
President
Phone
(734) 422-8400

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
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

6255 Inkster Rd
Ste 103
Garden City, MI 48135-2577

Mailing address

6255 Inkster Rd
Ste 103
Garden City, MI 48135-2577
Phone (734) 422-8400

Other identifiers 1

IdentifierTypeStateIssuer
0H21975OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080721000267 MI Part B Supplier - Clinic/Group Practice 3779560818 Receives reassigned benefits from 5 practitioners
Practice locations: Garden City, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Great Lakes Orthopaedics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363564800000",
    "number": "1740375518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 INKSTER RD",
            "address_2": "STE 103",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352577",
            "telephone_number": "734-422-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 INKSTER RD",
            "address_2": "STE 103",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352577",
            "telephone_number": "734-422-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES ORTHOPAEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-03-18",
        "status": "A",
        "authorized_official_last_name": "LAWLEY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-422-8400",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0H21975",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.