Goodhope Medical Group

Primary specialty

ContractorTaxonomy code 171W00000X

Legal business name

GOODHOPE MEDICAL GROUP

Practice address

8981 George Ave
Berrien Springs, MI 49103-1407

Phone

(269) 471-9436

NPI assigned

Mar 1, 2011

Last updated

Mar 1, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

LAKE REGION MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

Dr. Charles Mosimbwa, MDNPI 1215134408

Title

Medical Director

Phone

(269) 471-9436

Specialties & licenses 1

Addresses

Tax ID family

Goodhope Medical Group2 organizations share this tax ID, including this one

Part of

Goodhope Medical Group

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lake Region Medical Center, P.C.

  • Family Medicine Physician
  • Berrien Springs, MI
  • NPI 1912105602
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Andrew Mosimbwa, M.D.

  • Internal Medicine Physician
  • Niles, MI
  • NPI 1215134408
  NPD (past) Authorized official

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298937600000",
    "number": "1851699870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8981 GEORGE AVE",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8981 GEORGE AVE",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031407",
            "telephone_number": "269-471-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODHOPE MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE REGION MEDICAL CENTER",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A",
        "authorized_official_last_name": "MOSIMBWA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "269-471-9436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Contractor in Berrien Springs, MI
• Providers in Berrien Springs, MI by specialty
• Contractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.