Kalmazoo Gastroenterology Hepatology and Digestive Health Center

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601006118 Issued in MI

Legal business name

KALMAZOO GASTROENTEROLOGY HEPATOLOGY AND DIGESTIVE HEALTH CENTER

Practice address

1535 Gull Rd Ste 105
Kalamazoo, MI 49048-1630

Phone

(269) 385-9900

Fax

(269) 385-2140

NPI assigned

Aug 30, 2011

Organization subpart

Yes

Parent organization

PARAGON HEALTHAs reported in NPPES

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

Authorized official

Name

Mr. Lance Lincoln Pride, PAC

Title

Physician Assistant

Phone

(269) 385-9900

Specialties & licenses 1

Addresses

Part of

Paragon Health PC

Locations

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1831470285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 GULL RD STE 105",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481630",
            "telephone_number": "269-385-9900",
            "fax_number": "269-385-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 GULL RD STE 105",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481630",
            "telephone_number": "269-385-9900",
            "fax_number": "269-385-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALMAZOO GASTROENTEROLOGY HEPATOLOGY AND DIGESTIVE HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARAGON HEALTH",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "PRIDE",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "LINCOLN",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "269-385-9900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PAC"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalamazoo Valley Family Practice PC
• Cleopas Allan Kaliati
• Nancy Jean Kalinowski, M.D.
• Sandra Kaliszak, CRNA
• John Thomas Kallas, CRNA
• Indira K Kalmbach, M.A.
• Kaltherapy PC
• Lily Kalupa
• Sanja Kaluza, M.D.
• Brian Michael Kamer, D.O.

• Medical Physician Assistant in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.