NPIMap

Organization Active NPI

Michigan State University

  • Diagnostic Radiology Physician
  • East Lansing, MI
National Provider Identifier
1922265941
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MICHIGAN STATE UNIVERSITY
Practice address
East Circle Dr
Olin Health Center
East Lansing, MI 48824-1037
Phone
(517) 355-4510
NPI assigned
May 19, 2008
Last updated
Apr 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Authorized official

Name
Mrs. Lisa M Rucker
Title
Enrollment & Patient Accts Manager
Phone
(517) 355-8462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

East Circle Dr
Olin Health Center
East Lansing, MI 48824-1037

Mailing address

804 Service Rd Ste A109F
East Lansing, MI 48824-7015
Phone (517) 884-2976

Other identifiers 1

IdentifierTypeStateIssuer
0C36058OtherMIBCBSM

National Provider Directory

National Provider Directory
Tax ID family
Msu Dept of Urology23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522886400000",
    "number": "1922265941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109F",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST CIRCLE DR",
            "address_2": "OLIN HEALTH CENTER",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241037",
            "telephone_number": "517-355-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2018-04-05",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ENROLLMENT & PATIENT ACCTS MANAGER",
        "authorized_official_telephone_number": "517-355-8462",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0C36058",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.