NPIMap

Organization Active NPI

Lakeland Medical Practices

Doing business as Lakeland Family Medicine

  • Clinic/Center
  • Niles, MI
National Provider Identifier
1801116785
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LAKELAND MEDICAL PRACTICES
Doing business as
Lakeland Family Medicine
Practice address
4 Longmeadow Village Dr
Niles, MI 49120-7809
Phone
(269) 684-6000
Fax
(269) 684-1388
NPI assigned
Jun 2, 2010
Last updated
Mar 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Authorized official

Name
Warren White
Title
Vice President Physician Practices
Phone
(269) 983-8304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

4 Longmeadow Village Dr
Niles, MI 49120-7809

Mailing address

4 Longmeadow Village Dr
Niles, MI 49120-7809
Phone (269) 684-6000

Other identifiers 1

IdentifierTypeStateIssuer
1538397120MedicaidMI

Other names 1

  • Lakeland Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakeland Medical Practices49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1801116785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LONGMEADOW VILLAGE DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207809",
            "telephone_number": "269-684-6000",
            "fax_number": "269-684-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 LONGMEADOW VILLAGE DR",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207809",
            "telephone_number": "269-684-6000",
            "fax_number": "269-684-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "VICE PRESIDENT PHYSICIAN PRACTICES",
        "authorized_official_telephone_number": "269-983-8304"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538397120",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.