Organization Active NPI

Lansing Osteopathic Medical Group PC

  • Primary Care Clinic/Center
  • Okemos, MI
National Provider Identifier
1750530721
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
5101006090 Issued in MI
Legal business name
LANSING OSTEOPATHIC MEDICAL GROUP PC
Practice address
4655 Dobie Rd
Suite 260
Okemos, MI 48864-2233
Phone
(517) 482-1183
Fax
(517) 482-9877
NPI assigned
Sep 15, 2008
Last updated
Sep 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Dr. Jerry J Chandler, D.O.NPI 1376629287
Title
Physician
Phone
(517) 482-1183

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 5101006090 MI Primary
Family Medicine Physician 207Q00000X 5101006090 MI

Addresses

Primary practice location

4655 Dobie Rd
Suite 260
Okemos, MI 48864-2233

Mailing address

4655 Dobie Rd
Suite 260
Okemos, MI 48864-2233
Phone (517) 482-1183

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080923000838 MI Part B Supplier - Clinic/Group Practice 5597832170 Receives reassigned benefits from 1 practitioner
Practice locations: Okemos, MI

National Provider Directory

National Provider Directory

Locations

2248 Mount Hope Rd
Ste 100
Okemos, MI 48864
Phone (517) 482-1183

4655 Dobie Rd
Ste 260
Okemos, MI 48864
Phone (517) 482-1183

Practitioners & affiliated clinicians

Practitioners 1

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": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1750530721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 DOBIE RD",
            "address_2": "SUITE 260",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642233",
            "telephone_number": "517-482-1183",
            "fax_number": "517-482-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 DOBIE RD",
            "address_2": "SUITE 260",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642233",
            "telephone_number": "517-482-1183",
            "fax_number": "517-482-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANSING OSTEOPATHIC MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "CHANDLER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "517-482-1183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "5101006090",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101006090",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.