McLaren Greater Lansing

Organization Active NPI Family Medicine Physician · Okemos, MI

NPI 1972878452 · NPPES record last updated Aug 12, 2021

Key facts

NPI
1972878452
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MCLAREN GREATER LANSING
Practice address
2270 Jolly Oak Rd Ste 1
Okemos, MI 48864-6932
Phone
(517) 975-9475
NPI assigned
Mar 15, 2012
Organization subpart
No

Authorized official

Name
Mr. Dale Thompson
Title
Cfo
Phone
(517) 975-7555

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 122

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

View all 122

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20121226000286 MI Part B Supplier - Clinic/Group Practice 7214833466 Receives reassigned benefits from 54 practitioners
1 other NPI on this enrollment
Practice locations: Lansing, MI; Dewitt, MI; Okemos, MI; Grand Ledge, MI; Eaton Rapids, MI; East Lansing, MI

National Provider Directory

Locations

2104 Jolly Rd
Ste 220
Okemos, MI 48864
Phone (517) 381-2700

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Sports Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QS0010X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Hematology (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RH0000X
Hematology & Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RH0003X
Medical Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363AM0700X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X

Addresses

Primary practice location

2270 Jolly Oak Rd Ste 1
Okemos, MI 48864-6932

Mailing address

2270 Jolly Oak Rd Ste 1
Okemos, MI 48864-6932
Phone (517) 975-9475

Other providers in Okemos, MI

All providers in Okemos, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.