LAKELAND COMMUNITY HOSPITAL WATERVLIET (NPI# 1083710701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083710701 |
Entity Type | Organization |
Organization Name | LAKELAND COMMUNITY HOSPITAL WATERVLIET |
Practice Address |
6701 Paw Paw Ave Coloma MI 49038-9519 |
Mailing Address |
400 Medical Park Drive Watervliet MI 49098 |
Practice Telephone | 2694686430 |
Practice Fax Number | 2694680013 |
Mailing Telephone | 2694632448 |
Mailing Fax Number | 2694635351 |
Enumeration Date | 2006-09-16 |
Last Update Date | 2018-04-06 |
Authorized Official Name | TIM J CALHOUN (VP FINANCE/CFO) |
Authorized Official Telephone | 2699838300 |
Is Organization Subpart | Y |
Parent Organization Name | LAKELAND REGIONAL HEALTH SYSTEM |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | BCBSM | 700A110160 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568644052 | Lakeland Community Hospital Watervliet | Family Medicine | 400 Medical Park Drive, Watervliet, MI 49098 | 2007-11-27 |
1538592753 | Lakeland Community Hospital Watervliet | Clinic/Center | 2002 S 11th St, Niles, MI 49120-4074 | 2013-08-12 |
1033243399 | Lakeland Community Hospital Watervliet | Rehabilitation Unit | 400 Medical Park Dr, Watervliet, MI 49098-9225 | 2007-03-16 |
1508924770 | Lakeland Community Hospital Watervliet | Emergency Medicine | 400 Medical Park Dr, Watervliet, MI 49098-9225 | 2006-12-04 |
1023114741 | Lakeland Community Hospital Watervliet | Family Medicine | 525 S Center St, Hartford, MI 49057-1362 | 2006-09-16 |
1700994845 | Lakeland Community Hospital Watervliet | General Acute Care Hospital | 400 Medical Park Dr, Watervliet, MI 49098-9225 | 2006-08-28 |
Street Address |
6701 PAW PAW AVE |
City | COLOMA |
State | MI |
Zip Code | 49038-9519 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932191202 | Jaime Rodriguez | Pediatrics | 6701 Paw Paw Ave, Coloma, MI 49038-9519 | 2005-08-22 |
1265898878 | Brandi Smith | Nurse Practitioner | 6701 Paw Paw Ave, Coloma, MI 49038 | 2016-01-12 |
1609219070 | Susan Kasko | Family Medicine | 6701 Paw Paw Ave, Coloma, MI 49038-9519 | 2013-04-16 |
1851403307 | Michael E Mayle | Family Medicine | 6701 Paw Paw Ave, Coloma, MI 49038-9519 | 2006-08-31 |
1942253612 | Edwin Keith Newington | Family Medicine | 6701 Paw Paw Ave, Coloma, MI 49038-9519 | 2006-05-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528494135 | Gerald Carl Thiele | Hearing Instrument Specialist | 6693 Red Arrow Hwy, Coloma, MI 49038 | 2013-09-16 |
1518283100 | Jeffrey Thomas Perrapato | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6270 Lakewood Pointe Drive, Coloma, MI 49038 | 2010-04-08 |
1316123102 | Moss Chiropractic Clinic P.C. | Chiropractor | 429 N. Paw Paw Street, Coloma, MI 49038 | 2008-01-11 |
1386848745 | Daniel A Iliff | Chiropractor | 6560 Red Arrow Highway, Coloma, MI 49038 | 2007-06-12 |
1598711939 | Darlene Suzanne Bruner-getz | Dentist | 213 N Paw Paw St, Coloma, MI 49038 | 2006-05-26 |
1194295782 | Jeremy B Shelley | Physical Therapist | 7040 Red Arrow Hwy, Coloma, MI 49038 | 2018-11-27 |
1144866906 | Healing Counseling Services LLC | Social Worker | 6572 Red Arrow Hwy Ste 2, Coloma, MI 49038-8700 | 2019-11-26 |
1457540908 | Red Arrow Family Practice | General Practice | 6500 Red Arrow Hwy, Coloma, MI 49038-8700 | 2007-10-22 |
1962562397 | Susan L Startup | Social Worker | 6560 Red Arrow Hwy, Coloma, MI 49038-8700 | 2006-12-08 |
1700813227 | Judy D Henderson | Internal Medicine | 6572 Red Arrow Hwy, Coloma, MI 49038-8700 | 2006-06-28 |
Find all providers in zip 49038 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
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1326681461 | Munson Healthcare Charlevoix Hospital | Clinic/Center | 14719 W Upright St, Charlevoix, MI 49720-1949 | 2019-10-22 |
1881254605 | Schoolcraft Memorial Hospital | Clinic/Center | W11650 Us Highway 2, Naubinway, MI 49762-5116 | 2019-06-14 |
1093370264 | Samaritan Health Care, PC | Clinic/Center | 4361 220th Ave, Reed City, MI 49677-8594 | 2019-05-03 |
1457916637 | Samaritan Health Care, PC | Clinic/Center | 5916 Us Highway 31 S, Charlevoix, MI 49720-9703 | 2019-05-03 |
1033621263 | Caro Community Hospital | Clinic/Center | 345 N State St, Caro, MI 48723-1537 | 2017-10-27 |
1275050726 | Hills & Dales General Hospital, Inc. | Clinic/Center | 130 Millwood Street, Caro, MI 48723-1630 | 2017-08-25 |
1275932329 | Sturgis Hospital, Inc. | Clinic/Center | 111 S Saint Joseph St, Colon, MI 49040-9342 | 2014-08-14 |
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.