Great Lakes Health, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

4704175287 Issued in MI

Legal business name

GREAT LAKES HEALTH, LLC

Practice address

2726 N Saginaw Rd
Midland, MI 48640-2633

Phone

(989) 839-4560

Fax

(989) 839-4565

NPI assigned

Dec 18, 2013

Organization subpart

No

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

Authorized official

Name

Sara Aileen Crawford, ANP-BCNPI 1285680223

Title

Owner/Anp

Phone

(989) 839-4560

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8155/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Sara Aileen Crawford, N.P.

  • Adult Health Nurse Practitioner
  • Midland, MI
  • NPI 1285680223
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396396800000",
    "number": "1942621990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 N SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402633",
            "telephone_number": "989-839-4560",
            "fax_number": "989-839-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 N SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402633",
            "telephone_number": "989-839-4560",
            "fax_number": "989-839-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2014-04-02",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "AILEEN",
        "authorized_official_title_or_position": "OWNER/ANP",
        "authorized_official_telephone_number": "989-839-4560",
        "authorized_official_credential": "ANP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4704175287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1483761",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Gray, PT, DPT
• George H Grazul, CRNA
• Great Lakes Bay Health Centers
• Great Lakes Bay Hearing LLC
• Great Lakes Bay Orthodontics, PLC
• Great Lakes Home Care Unlimited LLC
• Great Lakes Home Care Unlimited LLC
• Great Lakes Pharmacy Midland, LLC
• Great Lakes Pharmacy Midland, LLC
• Mary L Greeley, RD

• Primary Care Clinic/Center in Midland, MI
• Providers in Midland, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.