Individual provider Active NPI

Jonathan Lauter

  • Pediatrics Physician
  • Troy, MI
National Provider Identifier
1962665869
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301092841 Issued in MI
Practice address
1800 W Big Beaver Rd Ste 200
Troy, MI 48084-3545
Phone
(248) 205-3535
Fax
(248) 649-5920
NPI assigned
Jul 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301092841 MI Primary

Addresses

Primary practice location

1800 W Big Beaver Rd Ste 200
Troy, MI 48084-3545

Mailing address

1800 W Big Beaver Rd Ste 200
Troy, MI 48084-3545
Phone (248) 205-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301092841MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Care of Virginia PC Current Accepting new patients
Child Health Associates PC Pediatrics PastSince Jun 6, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jonathanlauter@childhlthpc.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1962665869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W BIG BEAVER RD STE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843545",
            "telephone_number": "248-205-3535",
            "fax_number": "248-649-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W BIG BEAVER RD STE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843545",
            "telephone_number": "248-205-3535",
            "fax_number": "248-649-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTER",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301092841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.