M-15 Family Medical Center P C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101011488 Issued in MI

Legal business name

M-15 FAMILY MEDICAL CENTER P C

Practice address

7736 Ortonville Rd
Suite a
Clarkston, MI 48348-4483

Phone

(248) 625-5885

Fax

(248) 625-6794

NPI assigned

Feb 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Larry J. Baylis, D.O.NPI 1902847510

Title

President

Phone

(248) 625-5885

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Larry J Baylis, D.O.

  • Family Medicine Physician
  • Clarkston, MI
  • NPI 1902847510
  Medicare reassignment Care Compare group NPD Authorized official
• Teri L Shermetaro, D.O.

  • Family Medicine Physician
  • Clarkston, MI
  • NPI 1720029044
  Medicare reassignment Care Compare group NPD
• Sarah Maria Tereau, AGPCNP

  • Primary Care Nurse Practitioner
  • Clarkston, MI
  • NPI 1922880152
  NPD (past)
• Leigh Wilson, FNP

  • Family Nurse Practitioner
  • Clarkston, MI
  • NPI 1841663119
  NPD (past)

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1811962376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7736 ORTONVILLE RD",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483484483",
            "telephone_number": "248-625-5885",
            "fax_number": "248-625-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7736 ORTONVILLE RD",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483484483",
            "telephone_number": "248-625-5885",
            "fax_number": "248-625-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M-15 FAMILY MEDICAL CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "BAYLIS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-625-5885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101011488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5630195",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080127004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Mae Lumm
• Keon Luzod, LLMSW
• Elizabeth Joanne Lynch, BEHAVIOR TECHNICIAN
• Jessica Marie Lynch
• Kristel Anne Lynn, LLBSW
• Matthew Steven Maas, PA-C
• Allyssa Machnik, LMSW
• Kris Mackson, RN
• Julia Magaluk
• Karl Magnuson

• Family Medicine Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.