LAKELAND MEDICAL PRACTICES (NPI# 1174038392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174038392 |
| Entity Type | Organization |
| Organization Name | LAKELAND MEDICAL PRACTICES |
| Other Organization Name | LAKELAND NEUROLOGY |
| Practice Address |
3950 Hollywood Rd Ste 230 Saint Joseph MI 49085-9158 |
| Practice Telephone | 2699850000 |
| Practice Fax Number | 2699850360 |
| Mailing Telephone | 2699850000 |
| Mailing Fax Number | 2699850360 |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2017-12-11 |
| Authorized Official Name | MORGAN VINCENT (MEDICAL STAFF COORDINATOR) |
| Authorized Official Telephone | 2699838282 |
| Is Organization Subpart | Y |
| Parent Organization Name | LAKELAND MEDICAL PRACTICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Lakeland Neurology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285270249 | Lakeland Medical Practices | Family Medicine | 9045 Old Us 31, Suite A, Berrien Springs, MI 49103 | 2019-11-25 |
| 1407329261 | Lakeland Medical Practices | Preventive Medicine | 2500 Niles Rd Ste 4, Saint Joseph, MI 49085-3225 | 2019-01-04 |
| 1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
| 1679074470 | Lakeland Medical Practices | Clinic/Center | 2500 Niles Rd Ste 9, Saint Joseph, MI 49085-3268 | 2018-02-27 |
| 1972821460 | Lakeland Medical Practices | Clinic/Center | 42 N. St. Joseph Ave., Suite 201, Niles, MI 49120-2208 | 2010-05-10 |
| 1902462682 | Lakeland Medical Practices | Family Medicine | 3950 Hollywood Rd Ste 270, Saint Joseph, MI 49085-9158 | 2019-05-17 |
| 1710483110 | Lakeland Medical Practices | Clinic/Center | 4077 S Cleveland Ave, Saint Joseph, MI 49085-9513 | 2018-04-04 |
| 1336657824 | Lakeland Medical Practices | Psychiatry & Neurology | 6559 Paw Paw Ave, Coloma, MI 49038-8805 | 2018-01-18 |
| 1164961967 | Lakeland Medical Practices | Internal Medicine | 61 N Saint Joseph Ave, Niles, MI 49120-2207 | 2017-02-14 |
| 1417493545 | Lakeland Medical Practices | Clinic/Center | 2990 Niles Rd, Saint Joseph, MI 49085-8607 | 2017-01-12 |
| Street Address |
3950 HOLLYWOOD RD STE 230 |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-9158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639657729 | Michael Alan Schiman | Nurse Practitioner | 3950 Hollywood Rd Ste 230, Saint Joseph, MI 49085-9158 | 2018-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758949 | Ahmed Elshareif | Student in an Organized Health Care Education/Training Program | Lakeland Health, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2020-04-03 |
| 1033747225 | Ezra Fox | Student in an Organized Health Care Education/Training Program | Lakeland Health- Gme, 1234 Napier Avenue, St. Joseph, MI 49085 | 2020-04-01 |
| 1679033930 | Asad Butt | Student in an Organized Health Care Education/Training Program | Lakeland Health-gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2019-03-22 |
| 1184194714 | Benjamin Phillip Knuth | Physical Therapist | 3950 Hollywood Road, Suite 140, Saint Joseph, MI 49085 | 2018-11-27 |
| 1336624279 | Brandi Chatot | Counselor | 1101 Broad Street #8, Saint Joseph, MI 49085 | 2018-09-26 |
| 1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
| 1760976518 | Premier Health Associates, Inc. | Home Health | 1111 Main Sr, St Joseph, MI 49085 | 2018-06-15 |
| 1053817783 | Chantell Strong | Student in an Organized Health Care Education/Training Program | Lakeland Health - Gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2018-04-02 |
| 1386144053 | Anjana Gupta, Dds, Pllc | Dentist | 2800 Niles Road, Saint Joseph, MI 49085 | 2018-02-19 |
| 1356858997 | Hope Reborn Counseling, Pllc | Counselor | 2816 Willa Dr, Saint Joseph, MI 49085 | 2018-01-04 |
| Find all providers in zip 49085 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629033428 | Mark Alon Mandelbaum | Psychiatry & Neurology | 105 Far West Dr Ste 201, Saint Joseph, MO 64506 | 2006-04-18 |
| 1417368986 | Chelsea Allison Meyer | Psychiatry & Neurology | 105 Far West Dr Ste 201, Saint Joseph, MO 64506-3514 | 2014-05-18 |
| 1346387784 | Berrien Regional Associates In Neurology,pllc | Psychiatry & Neurology | 3950 Hollywood Rd, Ste 230, Saint Joseph, MI 49085-9159 | 2007-02-01 |
| 1639283369 | David L Ewing | Psychiatry & Neurology | 105 Far West Dr, Ste 201, Saint Joseph, MO 64506-3511 | 2006-08-19 |
| 1669479432 | Peter Benjamin Spencer | Psychiatry & Neurology | 3950 Hollywood Rd, 230, Saint Joseph, MI 49085-9159 | 2005-07-07 |
| 1598762379 | Robert Campbell Ward IIi | Psychiatry & Neurology | 3950 Hollywood Rd, Suite 230, Saint Joseph, MI 49085-9159 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738545 | Tank Consultation Pllc | Psychiatry & Neurology | 6095 Mcallister Ct Se, Grand Rapids, MI 49546-3836 | 2020-07-31 |
| 1417578535 | Angelique Maria Manasseh | Psychiatry & Neurology | 28521 Orchard Lake Rd Ste B, Farmington Hills, MI 48334-2934 | 2020-04-29 |
| 1306473418 | International Medical Clinic Pllc | Psychiatry & Neurology | 26100 American Dr Ste 200, Southfield, MI 48034-2367 | 2020-03-26 |
| 1720636657 | Muhammad Irshad Khan | Psychiatry & Neurology | 4201 Saint Antoine St Ste Uhc -8d, Detroit, MI 48201-2153 | 2019-09-04 |
| 1992261481 | Lucid Neurology PC | Psychiatry & Neurology | 26400 W 12 Mile Rd Ste 20, Southfield, MI 48034-1774 | 2019-02-20 |
| 1417427352 | Ascension St. Mary's Hospital | Psychiatry & Neurology | 4705 Towne Centre Rd Ste 302, Saginaw, MI 48604-2819 | 2018-12-04 |
| 1205326873 | Montana Neurology Pllc | Psychiatry & Neurology | 2040 Grand River Anx Ste 200, Brighton, MI 48114 | 2018-05-18 |
| 1508353145 | Kalyan Yarraguntla | Psychiatry & Neurology | 4201 Saint Antoine St # 8c, Detroit, MI 48201-2153 | 2018-04-19 |
| 1225525389 | Ahmad Ballout | Psychiatry & Neurology | 27358 Michele St, Dearborn Heights, MI 48127-1809 | 2018-04-15 |
| 1245734730 | E.i. Neurology Associates, Pllc | Psychiatry & Neurology | 15945 19 Mile Rd Ste 106, Clinton Township, MI 48038-1147 | 2018-03-20 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 49085 |
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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.