JOHN STREET CLINIC PC (NPI# 1033253133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033253133 |
| Entity Type | Organization |
| Organization Name | JOHN STREET CLINIC PC |
| Practice Address |
112 E John St Lake City MI 49651 |
| Mailing Address |
Po Box 213 Cadillac MI 49601-0213 |
| Practice Telephone | 2318394359 |
| Practice Fax Number | 2318390223 |
| Mailing Telephone | 2317756076 |
| Mailing Fax Number | 2317750027 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2010-08-05 |
| Authorized Official Name | SOTERO M URETA (OWNER) |
| Authorized Official Telephone | 2318394359 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
112 E JOHN ST |
| City | LAKE CITY |
| State | MI |
| Zip Code | 49651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205463312 | Andrea Huxtable | Student in an Organized Health Care Education/Training Program | 1800-200 S Sweetbriar Ave, Lake City, MI 49651 | 2020-03-26 |
| 1316482300 | Suzanne Smith | Massage Therapist | 102 B S. Main St, Lake City, MI 49651 | 2016-12-29 |
| 1184960734 | Shanel Lynette Seger | Occupational Therapy Assistant | 1900 S Lachance Road, Lake City, MI 49651 | 2012-12-28 |
| 1265705347 | David Robert Kramp | Physical Therapist | 1900 South Lachance Rd, Lake City, MI 49651 | 2012-02-20 |
| 1396072708 | Footprints In Time | Voluntary or Charitable | 805 Mitchell St., Lake City, MI 49651 | 2009-11-05 |
| 1184895336 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 1960 South Morey Road, Lake City, MI 49651 | 2008-03-17 |
| 1396965752 | Chris Klein Otr Plc | Occupational Therapist | 805 Mitchell St, Lake City, MI 49651 | 2007-04-26 |
| 1659435287 | Michael Francis Lahey | Dentist | 301 N Main, Lake City, MI 49651 | 2006-12-20 |
| 1215019781 | Christine Louise Klein | Occupational Therapist | 805 Mitchell, Lake City, MI 49651 | 2006-10-20 |
| 1952896151 | Lake City Primary Care PC | Clinic/Center | 1866 S Morey Rd, Lake City, MI 49651 | 2018-06-29 |
| Find all providers in zip 49651 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558655027 | Marianne Hazelitt | Internal Medicine | 1005 Sw Walter Ave, None, Lake City, FL 32024-1757 | 2011-06-02 |
| 1427380823 | Ankem Ravindra Md Pa | Internal Medicine | 1740 W Us Highway 90, Suite 101, Lake City, FL 32055-4718 | 2010-02-10 |
| 1437345907 | Richard J Misischia | Internal Medicine | 110 Industrial Park Ln, Lake City, TN 37769-2300 | 2007-09-19 |
| 1841481512 | Alex L Gonzales Md Pa | Internal Medicine | 4251 Nw American Lane, Ste 101, Lake City, FL 32055-4881 | 2007-08-07 |
| 1427254283 | Michael C Ukaegbu | Internal Medicine | 221 Sw Stonegate Ter Ste 101, Lake City, FL 32024-3463 | 2007-06-26 |
| 1598775850 | Gregory Lambourne | Internal Medicine | 1866 S Morey Rd, Lake City, MI 49651-9190 | 2006-08-09 |
| 1750398822 | Alex L Gonzales | Internal Medicine | 4251 Nw American Ln, Ste 101, Lake City, FL 32055-4881 | 2006-08-02 |
| 1699798074 | Mohammed G Choudhury, Mdpa. | Internal Medicine | 155 Nw Enterprise Way, Lake City, FL 32055-8837 | 2006-07-26 |
| 1174545271 | Sotero M Ureta IIi | Internal Medicine | 112 E John Street, Lake City, MI 49651-0629 | 2006-07-25 |
| 1750346714 | Krishnarao V Tummala | Internal Medicine | 619 S .marion Ave, Lake City Va Medical Center, Lake City, FL 32025 | 2006-04-20 |
| Find all providers in LAKE CITY | ||||
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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.