NPIMap

Organization Active NPI

Integrative Functional Medicine Wellness

  • Family Medicine Physician
  • Lansing, MI
National Provider Identifier
1831953496
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INTEGRATIVE FUNCTIONAL MEDICINE WELLNESS
Practice address
901 Brookside Dr Apt 105
Lansing, MI 48917-8210
Phone
(786) 945-5440
NPI assigned
Feb 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Dr. Luis Gaspar Maduro, MDNPI 1881813079
Title
Owner
Phone
(786) 945-5440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

901 Brookside Dr Apt 105
Lansing, MI 48917-8210

Mailing address

901 Brookside Dr Apt 105
Lansing, MI 48917-8210
Phone (786) 945-5440

National Provider Directory

National Provider Directory

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": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1831953496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BROOKSIDE DR APT 105",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489178210",
            "telephone_number": "786-945-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BROOKSIDE DR APT 105",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489178210",
            "telephone_number": "786-945-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE FUNCTIONAL MEDICINE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "MADURO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "GASPAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-945-5440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.