MCLAREN MEDICAL GROUP (NPI# 1164614798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164614798 |
| Entity Type | Organization |
| Organization Name | MCLAREN MEDICAL GROUP |
| Other Organization Name | MCLAREN MEDICAL MANAGEMENT, INC |
| Practice Address |
2420 Owen Rd Fenton MI 48430-3417 |
| Mailing Address |
401 S Ballenger Hwy Flint MI 48532-3638 |
| Practice Telephone | 8104962400 |
| Practice Fax Number | 8106290918 |
| Mailing Telephone | 8103421000 |
| Mailing Fax Number | 8103421590 |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2016-04-04 |
| Authorized Official Name | MR. WILLIAM HARDIMON (CEO) |
| Authorized Official Telephone | 8103421040 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCLAREN MEDICAL MANAGEMENT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CARE NETWORK | 700B511870 | 01 |
| Other Name | Type Code |
|---|---|
| McLaren Medical Management, Inc | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114066693 | Mclaren Medical Group | Advanced Practice Midwife | 1198 N Belsay Rd, Building 3, Burton, MI 48509-1669 | 2007-02-05 |
| 1053458091 | Mclaren Medical Group | Obstetrics & Gynecology | 2521 N Elms Rd, Flushing, MI 48433-9426 | 2007-01-31 |
| 1104294354 | Mclaren Medical Group | General Practice | 611 Court St, West Branch, MI 48661-8820 | 2015-09-04 |
| 1629369988 | Mclaren Medical Group | Internal Medicine | 3720 Katalin Ct, Bay City, MI 48706-2160 | 2011-04-21 |
| 1649435223 | Mclaren Medical Group | Emergency Medicine | 43900 Garfield Rd, Suite 121, Clinton Township, MI 48038-1128 | 2008-07-23 |
| 1528100781 | Mclaren Medical Group | Advanced Practice Midwife | 3175 Professional Ct, Bay City, MI 48706-2823 | 2007-02-13 |
| 1306983176 | Mclaren Medical Group | Pediatrics | 1254 N Main St, Lapeer, MI 48446-1343 | 2007-01-31 |
| 1073650750 | Mclaren Medical Group | Radiology | 1254 N Main St, Lapeer, MI 48446-1343 | 2007-01-31 |
| 1922145606 | Mclaren Medical Group | Surgery | 1254 N Main St, Lapeer, MI 48446-1343 | 2007-01-31 |
| 1659418663 | Mclaren Medical Group | Internal Medicine | 1459 S Center Rd, Burton, MI 48509-1726 | 2007-01-31 |
| Street Address |
2420 OWEN RD |
| City | FENTON |
| State | MI |
| Zip Code | 48430-3417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821088162 | Soon A Choi | Internal Medicine | 2420 Owen Rd, Fenton, MI 48430-3417 | 2005-10-27 |
| 1619258571 | Dale M Williams | Pharmacist | 2420 Owen Rd, Fenton, MI 48430-3417 | 2011-09-06 |
| 1255568523 | Shelly Marie Oles | Nurse Practitioner | 2420 Owen Rd, Fenton, MI 48430-3417 | 2009-06-15 |
| 1639351497 | Brian Andrew Michalkow | Dentist | 2420 Owen Rd, Suite E, Fenton, MI 48430-3417 | 2007-12-03 |
| 1780767145 | Larry L Pack Md PC | Orthopaedic Surgery | 2420 Owen Rd, Ste C, Fenton, MI 48430-3417 | 2006-10-21 |
| 1992887046 | David George Drake | Dentist | 2420 Owen Rd, Fenton, MI 48430-3417 | 2006-10-19 |
| 1043309933 | Shaheen K Mohammed | Internal Medicine | 2420 Owen Rd, Fenton, MI 48430-3417 | 2006-10-11 |
| 1538173752 | Steven Nick Glavas | Family Medicine | 2420 Owen Rd, Fenton, MI 48430-3417 | 2006-07-27 |
| 1548230527 | David F Schwarz | Family Medicine | 2420 Owen Rd, Fenton, MI 48430-3417 | 2006-01-24 |
| 1477534774 | Larry L. Pack | Orthopaedic Surgery | 2420 Owen Rd, Ste C, Fenton, MI 48430-3417 | 2005-11-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1366994410 | Intentional Wellbeing LLC | Psychologist | 1122 N. Leroy Rd, Suite A, Fenton, MI 48430 | 2016-10-25 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326085457 | James R Taylor | Emergency Medicine | 1015 Bowles Ave., Fenton, MO 63026 | 2006-05-31 |
| 1982687059 | Robert Brunton Smith | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2005-11-22 |
| 1093360414 | Cep America LLC | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2019-08-02 |
| 1437681418 | Matthew Schwab | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2017-03-30 |
| 1558502989 | Midwest Emergency Associates-fenton, LLC | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2009-03-16 |
| 1376746800 | Stephen Slowik | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2007-06-11 |
| 1275643553 | Patricia A. Williams | Emergency Medicine | 1203 Smizer Mill Rd, Suite 100, Fenton, MO 63026-3483 | 2006-08-30 |
| 1730108101 | Tuere A Franklin | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026-2394 | 2006-07-18 |
| 1073538302 | Jeffrey J Hallazgo | Emergency Medicine | 714 Gravois Rd, Suite 100, Fenton, MO 63026-7723 | 2006-07-13 |
| 1437135217 | Joseph Theodore Young | Emergency Medicine | 1015 Bowles Ave, Fenton, MO 63026 | 2005-12-22 |
| Find all providers in FENTON | ||||
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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.