Four Flags Health Ventures,Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

FOUR FLAGS HEALTH VENTURES,INC

Practice address

122 Grant St
Niles, MI 49120-2281

Phone

(269) 684-0259

Fax

(269) 684-0189

NPI assigned

Dec 20, 2007

Organization subpart

Yes

Parent organization

LAKELAND REGIONAL HEALTH SYSTEMAs reported in NPPES

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

Authorized official

Name

Dennis Mack

Title

V.P.Operations & Facility Managemen

Phone

(269) 938-8399

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1871777227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 GRANT ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202281",
            "telephone_number": "269-684-0259",
            "fax_number": "269-684-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 GRANT ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202281",
            "telephone_number": "269-684-0259",
            "fax_number": "269-684-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR FLAGS HEALTH VENTURES,INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKELAND REGIONAL HEALTH SYSTEM",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "V.P.OPERATIONS & FACILITY MANAGEMEN",
        "authorized_official_telephone_number": "269-938-8399"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Ford, CRNA
• Marlene Ford, CRNA
• Valerie Christine Fordyce, LMT
• Jeremy Sean Forray-Molica, LMSW, CADC
• Paula L Fortune, MSPT
• Four Flags Urology, Inc.
• Daren Denzel Fox, MA, TLLP
• William Hayden Fox, DPM
• Joe Francisco, MSW, LCSW
• Rebecca Lynn Frantz, AGACNP-BC

• Health Maintenance Organization in Niles, MI
• Providers in Niles, MI by specialty
• Health Maintenance Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.