Laurence Habenicht, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301074430 Issued in MI

Practice address

42 N Saint Joseph Ave
Suite100
Niles, MI 49120-2203

Phone

(269) 684-6696

Fax

(269) 684-5286

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeland Medical Practices

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment NPD
• Lakeland Medical Practices

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1851363618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 N SAINT JOSEPH AVE",
            "address_2": "SUITE100",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202203",
            "telephone_number": "269-684-6696",
            "fax_number": "269-684-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 N SAINT JOSEPH AVE",
            "address_2": "SUITE100",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202203",
            "telephone_number": "269-684-6696",
            "fax_number": "269-684-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABENICHT",
        "first_name": "LAURENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301074430",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301074430",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411815210",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shane Guffey
• Thomas Hadley Gustafson, DPT
• Edmund Curtin Guyer, D.D.S., M.S.
• Elizabeth Ann Habben
• Deborah Habenicht, M.D.
• Haelan Counseling Center
• Amanda Marie Haines
• Eunice Hamilton, RN, FNP-BC
• Maurice D Hampton, LLMSW
• Sheryl Kay Hancock, RN

• Specialist in Niles, MI
• Providers in Niles, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.