NPIMap

Organization Active NPI

Great Lakes Anesthesia Indiana and Michigan, PLLC

  • Anesthesiology Physician
  • Sturgis, MI
National Provider Identifier
1891069605
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GREAT LAKES ANESTHESIA INDIANA AND MICHIGAN, PLLC
Practice address
916 Myrtle St
Sturgis, MI 49091-2326
Phone
(574) 522-9922
Fax
(574) 522-9926
NPI assigned
Feb 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Authorized official

Name
Robert Bart Powers, D.O.NPI 1528065190
Title
Owner/Board Member
Phone
(574) 522-9922

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

916 Myrtle St
Sturgis, MI 49091-2326

Mailing address

PO Box 686
Indianapolis, IN 46206-0686
Phone (574) 522-9922

Other identifiers 4

IdentifierTypeStateIssuer
0G50067OtherMIANTHEM
1891069605MedicaidMI
0G50066OtherMIANTHEM
DS9802OtherMIRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1891069605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 686",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462060686",
            "telephone_number": "574-522-9922",
            "fax_number": "574-522-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 MYRTLE ST",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490912326",
            "telephone_number": "574-522-9922",
            "fax_number": "574-522-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES ANESTHESIA INDIANA AND MICHIGAN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BART",
        "authorized_official_title_or_position": "OWNER/BOARD MEMBER",
        "authorized_official_telephone_number": "574-522-9922",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0G50067",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891069605",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0G50066",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DS9802",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgis, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.