LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES (NPI# 1003924739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003924739 |
| Entity Type | Organization |
| Organization Name | LAKESHORE INTERNAL MEDICINE AND PEDIATRIC ASSOCIATES |
| Practice Address |
437 North 120th Ave Holland MI 49424 |
| Practice Telephone | 6167380737 |
| Mailing Telephone | 6167380737 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2016-06-07 |
| Authorized Official Name | BARBARA MARTIN (BILLING) |
| Authorized Official Telephone | 6164536329 |
| Authorized Official Credential | CPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
4301074294 | MI | Ambulatory Health Care Facilities |
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
4301074445 | MI | Ambulatory Health Care Facilities |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
4301066494 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4193863 | 05 | |
| MI | 4529541 | 05 | |
| MI | 4531728 | 05 |
| Street Address |
437 NORTH 120TH AVE |
| City | HOLLAND |
| State | MI |
| Zip Code | 49424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326155904 | Gregory A Schrotenboer | Internal Medicine | 437 North 120th Ave, Holland, MI 49424 | 2006-08-23 |
| 1033226618 | Tricia R Miller | Internal Medicine | 437 North 120th Ave, Holland, MI 49424 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290999 | Anderson Family and Cosmetic Dentistry | Dentist | 453 136th Ave., Holland, MI 49424 | 2018-10-08 |
| 1487139663 | Maria C. Hoekstra Dds, P.C. | Dentist | 1121 Ottawa Beach Road, Suite 100, Holland, MI 49424 | 2018-10-03 |
| 1871024000 | Derek Schaaf | Rehabilitation Practitioner | 13835 Foxtrail Dr., Holland, MI 49424 | 2017-03-21 |
| 1699227397 | Tabitha Margritz | Optometrist | 2279 N Park Drive #910, Holland, MI 49424 | 2016-10-28 |
| 1619373701 | Miller Chiropractic LLC | Chiropractor | 84 East Lakewood Boulevard, Holland, MI 49424 | 2014-11-17 |
| 1891107611 | Nathan B. Poel | Dentist | 1180 Ottawa Beach Rd, Suite E, Holland, MI 49424 | 2014-05-28 |
| 1477990802 | Jeanine Hamilton | Speech-Language Pathologist | 1576 Eb Creek Dr., Holland, MI 49424 | 2013-05-24 |
| 1194062638 | Stefan John Kuipers | Physician Assistant | 3100 Wellness Dr, Holland, MI 49424 | 2013-01-03 |
| 1902155690 | Benjamin Eovaldi | General Practice | 376 Mayfair St., Holland, MI 49424 | 2012-09-10 |
| 1295017929 | Employee Assistance Center Garden | Psychologist | 372 Garden, Holland, MI 49424 | 2011-09-20 |
| Find all providers in zip 49424 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1619584570 | Crossover Health Medical Group | Clinic/Center | 19901 Dix Toledo Hwy, Brownstown Twp, MI 48183-1039 | 2020-09-24 |
| 1669087854 | Advance Counseling Services, LLC | Clinic/Center | 110 Trealout Dr Ste 103, Fenton, MI 48430-3211 | 2020-09-14 |
| 1104439033 | Otevwa Homes Inc | Clinic/Center | 6556 Rustic Ridge Trl, Grand Blanc, MI 48439-4956 | 2020-08-29 |
| 1245849827 | Transitions Case Management Education Inc. | Clinic/Center | 26375 Halsted Rd Apt 122, Farmington Hills, MI 48331-3762 | 2020-07-29 |
| 1689204703 | Professional Ergonomics LLC | Clinic/Center | 1754 Central Park Dr Apt H, Okemos, MI 48864-1258 | 2020-01-16 |
| 1598319147 | Crescent Procedure Center Plc | Clinic/Center | 30671 Stephenson Hwy Ste A, Madison Heights, MI 48071-1635 | 2019-07-31 |
| 1164984944 | Rsf Medics Pllc | Clinic/Center | 28511 Ford Rd, Garden City, MI 48135 | 2019-04-02 |
| 1114484540 | Maan Ekkah, Md, PC | Clinic/Center | 4848 Adams Pointe Ct, Troy, MI 48098-4111 | 2019-02-21 |
| 1437639051 | Tlc Home and Respite Care LLC | Clinic/Center | 16910 Gardenview Cir, Detroit, MI 48228-4331 | 2018-08-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.