Great Lakes Medical PC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

04411G Issued in MI

Legal business name

GREAT LAKES MEDICAL PC

Practice address

1111 S Mission St
Mount Pleasant, MI 48858-3944

Phone

(989) 773-9700

Fax

(989) 779-9701

NPI assigned

Jan 25, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Richard Wayne Macauley, MEDICAL DOCTOR

Title

Owner

Phone

(517) 449-2452

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1942548946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 COURT ST",
            "address_2": "PO BOX 428",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619390",
            "telephone_number": "989-773-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S MISSION ST",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488583944",
            "telephone_number": "989-773-9700",
            "fax_number": "989-779-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "MACAULEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-449-2452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MEDICAL DOCTOR"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MI",
            "license": "04411G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Gordon
• Angela S Gorski
• Laura Christine Gourlay, M.A.
• Jeffery Ryan Govitz
• Christine L Gransden, NP
• Great Lakes Psychological Associates PLLC
• Great Lakes Spine Sports & Pain, PLLC
• Greater Michigan Spine & Neurologic Institute, PC
• Allison Green
• Katelyn Rae Green

• Rural Health Clinic/Center in Mount Pleasant, MI
• Providers in Mount Pleasant, MI by specialty
• Rural Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.