Great Lakes Research Group, Inc.

Primary specialty

Research Clinic/CenterTaxonomy code 261QR1100X

Legal business name

GREAT LAKES RESEARCH GROUP, INC.

Practice address

200 S Wenona St Ste 170
Bay City, MI 48706-8831

Phone

(989) 895-9100

Fax

(989) 895-9200

NPI assigned

Apr 2, 2018

Last updated

Apr 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Terri L Vittitow

Title

Site Director

Phone

(989) 895-9100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522627200000",
    "number": "1831695543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S WENONA ST STE 170",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487068831",
            "telephone_number": "989-895-9100",
            "fax_number": "989-895-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WENONA ST STE 170",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487068831",
            "telephone_number": "989-895-9100",
            "fax_number": "989-895-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES RESEARCH GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-02",
        "last_updated": "2018-04-02",
        "status": "A",
        "authorized_official_last_name": "VITTITOW",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SITE DIRECTOR",
        "authorized_official_telephone_number": "989-895-9100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Andrew Z Green, DDS
• Jordan Lynn Green
• Rachel Greenberg

• Research Clinic/Center in Bay City, MI
• Providers in Bay City, MI by specialty
• Research Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; 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.