Organization Active NPI

David W Lowry MD PC

  • Neurological Surgery Physician
  • Hollland, MI
National Provider Identifier
1790736692
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4301075621 Issued in MI
Legal business name
DAVID W LOWRY MD PC
Practice address
3299 North Wellness Dr
Suite 240 Building C
Hollland, MI 49424
Phone
(616) 738-4420
Fax
(616) 738-4432
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
David Warren Lowry, MD
Title
President
Phone
(616) 738-4420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 4301075621 MI Primary

Addresses

Primary practice location

3299 North Wellness Dr
Suite 240 Building C
Hollland, MI 49424

Mailing address

3299 North Wellness Dr
Suite 240 Building C
Hollland, MI 49424
Phone (616) 738-4420

Other identifiers 4

IdentifierTypeStateIssuer
1407010792OtherMIBCBSM MI
ST003962OtherMISTATE LICENSE #
DL075621OtherMISTATE LICENSE #
104721043MedicaidMI

National Provider Directory

National Provider Directory

Locations

1521 Momentum Pl
Chicago, IL 60689

1521 Monentum Pl
Chicago, IL 60689

3299 N Wellness Dr
Bldg C
Holland, MI 49424
Phone (616) 738-4420

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1790736692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3299 NORTH WELLNESS DR",
            "address_2": "SUITE 240 BUILDING C",
            "city": "HOLLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-738-4420",
            "fax_number": "616-738-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3299 NORTH WELLNESS DR",
            "address_2": "SUITE 240 BUILDING C",
            "city": "HOLLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-738-4420",
            "fax_number": "616-738-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W LOWRY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "LOWRY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-738-4420",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301075621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM MI",
            "identifier": "1407010792",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "ST003962",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "DL075621",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104721043",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.