Great Lakes Plastic Surgery Center

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

GREAT LAKES PLASTIC SURGERY CENTER

Practice address

5085 Anna Dr
Traverse City, MI 49684-9691

Phone

(231) 935-0180

Fax

(231) 935-0099

NPI assigned

Aug 9, 2007

Last updated

Aug 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Catherine S Francis

Title

Medical Biller

Phone

(231) 935-0180

Specialties & licenses 2

Addresses

Other identifiers 8

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1972795334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5085 ANNA DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849691",
            "telephone_number": "231-935-0180",
            "fax_number": "231-935-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5085 ANNA DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849691",
            "telephone_number": "231-935-0180",
            "fax_number": "231-935-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PLASTIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "FRANCIS",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "231-935-0180",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301067433",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "2402810821",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285614032",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4156180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4704192319",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437139318",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3495242",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "5008762590",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Great Lakes Integrated Health PLLC (Great Lakes Integrated Health)
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• Great Lakes Orthopaedic Center
• Great Lakes Orthopaedic Center, P.C.
• Great Lakes Orthopaedic Center, P.C.
• Great Lakes Support Services
• Great Lakes Therapy at Orchard Creek Campus
• Great Lakes Therapy House Calls PC (Great Lakes Physical Therapy Center)
• Great Lakes Therapy Housecalls, P.C. (Great Lakes Physical Therapy Center)
• Greater Heights Physical Therapy and Performance LLC

• Plastic and Reconstructive Surgery Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Plastic and Reconstructive Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.