Great Lakes Orthotics and Prosthetics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

GREAT LAKES ORTHOTICS AND PROSTHETICS

Practice address

2351 Stonebridge Dr
Flint, MI 48532-5407

Phone

(601) 594-2801

NPI assigned

Nov 5, 2024

Organization subpart

No

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

Authorized official

Name

Tyneshia L McFarland-Williams

Title

Employee

Phone

(601) 594-2801

Specialties & licenses 3

Addresses

Other names 1

• Great lakes O and P Doing business as

Locations

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1972326163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 ELK CREEK DR",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484738630",
            "telephone_number": "601-594-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 STONEBRIDGE DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485325407",
            "telephone_number": "601-594-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES ORTHOTICS AND PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "MCFARLAND-WILLIAMS",
        "authorized_official_first_name": "TYNESHIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "601-594-2801"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great lakes O and P",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Great Lakes Brain Spine Surgery and Pain Center PLLC
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• Great Lakes Dental Services PLLC
• Great Lakes Interventional Pain Management,PLLC
• Great Lakes Oral Surgery and Implants, P.C.
• Great Lakes Pain & Rehab, PC
• Great Lakes Recovery Mission
• Great Lakes Recovery Mission, LLC
• Great Lakes Recovery Mission, LLC
• Great Lakes Recovery Mission, LLC

• Prosthetic/Orthotic Supplier in Flint, MI
• Providers in Flint, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.