NPIMap

Organization Active NPI

Lakeland Medical Practices

Doing business as Lakeland Primary Care, Royalton

  • Internal Medicine Physician
  • Saint Joseph, MI
National Provider Identifier
1902462682
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LAKELAND MEDICAL PRACTICES
Doing business as
Lakeland Primary Care, Royalton
Practice address
3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158
Phone
(269) 982-7840
Fax
(269) 982-7843
NPI assigned
May 17, 2019
Organization subpart
Yes
Parent organization
LAKELAND MEDICAL PRACTICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Authorized official

Name
Morgan Vincent
Title
Coordinator
Phone
(269) 983-8282

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158

Mailing address

3950 Hollywood Rd Ste 270
Saint Joseph, MI 49085-9158
Phone (269) 982-7840

Other names 1

  • Lakeland Primary Care, Royalton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakeland Medical Practices49 organizations share this tax ID, including this one
Part of
Lakeland Medical Practices

Other organizations with this tax ID 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558051200000",
    "number": "1902462682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 270",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859158",
            "telephone_number": "269-982-7840",
            "fax_number": "269-982-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 270",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859158",
            "telephone_number": "269-982-7840",
            "fax_number": "269-982-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL PRACTICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKELAND MEDICAL PRACTICES",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-17",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "269-983-8282"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Primary Care, Royalton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.