George J Kelen MD PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

4301079843 Issued in MI

Legal business name

GEORGE J KELEN MD PLLC

Doing business as

Lakeshore Cardiology

Practice address

913 E Ludington Ave
Ludington, MI 49431-2437

Phone

(231) 845-7677

Fax

(231) 843-0773

NPI assigned

Jun 20, 2008

Last updated

Jul 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George John Kelen, MD, FACC

Title

Owner

Phone

(231) 845-7677

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lakeshore Cardiology Doing business as

Locations

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1891956918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 E LUDINGTON AVE",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312437",
            "telephone_number": "231-845-7677",
            "fax_number": "231-843-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 E LUDINGTON AVE",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312437",
            "telephone_number": "231-845-7677",
            "fax_number": "231-843-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE J KELEN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "KELEN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-845-7677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, FACC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MI",
            "license": "4301079843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4579580",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA9989",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeshore Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Fox Gasper
• Dawn Erin Gebhart
• Karen Carlson Genson, R.D.
• Dannie Joe Gentry Jr., M.D.
• Michelle Marie Gentry, FNP-BC
• Joseph Giammalva
• Michelle Giddings
• Ann Gilchrist
• Mary Ellen Gilchrist, FNP-C
• Devin A Gill, LMSW

• Medical Specialty Clinic/Center in Ludington, MI
• Providers in Ludington, MI by specialty
• Medical Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.