NPIMap

Organization Active NPI

Great Lakes Medical, P,C,

Doing business as Gladwin Urgent Care Center

  • Rural Health Clinic/Center
  • Gladwin, MI
National Provider Identifier
1750727129
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
04411G Issued in MI
Legal business name
GREAT LAKES MEDICAL, P,C,
Doing business as
Gladwin Urgent Care Center
Practice address
1277 E Cedar Ave
Suite a
Gladwin, MI 48624-7004
Phone
(989) 426-1100
NPI assigned
May 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Authorized official

Name
Dr. Richard Wayne Macauley, M.D.
Title
Owner
Phone
(517) 449-2452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 04411G MI Primary

Addresses

Primary practice location

1277 E Cedar Ave
Suite a
Gladwin, MI 48624-7004

Mailing address

1277 E Cedar Ave
Suite a
Gladwin, MI 48624-7004
Phone (989) 426-1100

Other identifiers 1

IdentifierTypeStateIssuer
04411GOtherMISTATE OF MICHIGAN ID

Other names 1

  • GLADWIN URGENT CARE CENTER 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": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1750727129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 E CEDAR AVE",
            "address_2": "SUITE A",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486247004",
            "telephone_number": "989-426-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 E CEDAR AVE",
            "address_2": "SUITE A",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486247004",
            "telephone_number": "989-426-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES MEDICAL, P,C,",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "MACAULEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-449-2452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MI",
            "license": "04411G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN ID",
            "identifier": "04411G",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLADWIN URGENT CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gladwin, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.