NPIMap

Organization Active NPI

Great Lakes Orthopaedic Center, P.C.

  • Orthopaedic Surgery Physician
  • Traverse City, MI
National Provider Identifier
1881312213
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GREAT LAKES ORTHOPAEDIC CENTER, P.C.
Practice address
401 Munson Ave
Traverse City, MI 49686-3041
Phone
(231) 935-0900
Fax
(231) 935-0905
NPI assigned
Aug 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Authorized official

Name
Chrissy Durga
Title
Billing and Coding Manager
Phone
(231) 929-5734

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

401 Munson Ave
Traverse City, MI 49686-3041

Mailing address

4045 W Royal Dr
Traverse City, MI 49684-8965

Other names 1

  • Great Lakes Orthopaedic Center East Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address 0566.0001@direct.gloc.nextgenshare.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: 0566.0001@direct.gloc.nextgenshare.com

Practitioners & affiliated clinicians

Practitioners 8

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": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1881312213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863041",
            "telephone_number": "231-935-0900",
            "fax_number": "231-935-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES ORTHOPAEDIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "DURGA",
        "authorized_official_first_name": "CHRISSY",
        "authorized_official_title_or_position": "BILLING AND CODING MANAGER",
        "authorized_official_telephone_number": "231-929-5734"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "0566.0001@direct.gloc.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Trust Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4045 W Royal Dr",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496848965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Great Lakes Orthopaedic Center East",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.