BRONSON LAKEVIEW HOSPITAL (NPI# 1235131137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235131137 |
| Entity Type | Organization |
| Organization Name | BRONSON LAKEVIEW HOSPITAL |
| Other Organization Name | BRONSON MEDICAL GROUP |
| Practice Address |
451 Health Pkwy Paw Paw MI 49079-8242 |
| Mailing Address |
301 John St Box 42 Kalamazoo MI 49007-5295 |
| Practice Telephone | 2696572550 |
| Practice Fax Number | 2696572285 |
| Mailing Telephone | 2693417806 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2020-09-16 |
| Authorized Official Name | REBECCA EAST (SVP, CFO) |
| Authorized Official Telephone | 2693416000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BRONSON LAKEVIEW HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | MI | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
MI | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MI | Allopathic & Osteopathic Physicians | |
| N | 208600000X | Surgery | MI | Allopathic & Osteopathic Physicians | |
| N | 207Q00000X | Family Medicine | MI | Allopathic & Osteopathic Physicians | |
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RHC-DECATUR | 238546 | 01 | |
| RHC-MARCELLUS | 238585 | 01 | |
| RHC-PAW PAW | 238601 | 01 | |
| RHC-LAWTON | 238600 | 01 |
| Other Name | Type Code |
|---|---|
| Bronson Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104459627 | Bronson Lakeview Hospital | Clinic/Center | 520 Railroad St, Bangor, MI 49013-1490 | 2020-02-13 |
| 1740424068 | Bronson Lakeview Hospital | Nurse Anesthetist, Certified Registered | 601 John St, Box 42, Kalamazoo, MI 49007-5341 | 2009-04-30 |
| 1639313174 | Bronson Lakeview Hospital | Psychologist | 404 Hazen St, Suite L3, Paw Paw, MI 49079-1040 | 2009-04-28 |
| 1376767285 | Bronson Lakeview Hospital | Family Medicine | 319 W Delaware St, Decatur, MI 49045-1106 | 2007-04-12 |
| 1629292446 | Bronson Lakeview Hospital | Family Medicine | 310 White Oak Rd, Lawton, MI 49065-9705 | 2007-04-12 |
| 1538383351 | Bronson Lakeview Hospital | Family Medicine | 110 E Main St, Marcellus, MI 49067-8523 | 2007-04-12 |
| 1447474267 | Bronson Lakeview Hospital | Family Medicine | 52375 N Main St, Mattawan, MI 49071-9332 | 2007-04-12 |
| 1356565170 | Bronson Lakeview Hospital | General Acute Care Hospital | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2007-04-12 |
| 1750482444 | Bronson Lakeview Hospital | Psychiatric Unit | 408 Hazen St, Paw Paw, MI 49079-1019 | 2006-09-26 |
| 1962508259 | Bronson Lakeview Hospital | General Acute Care Hospital | 408 Hazen St, Paw Paw, MI 49079-1019 | 2006-09-15 |
| Street Address |
451 HEALTH PKWY |
| City | PAW PAW |
| State | MI |
| Zip Code | 49079-8242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115183 | Pamela Nelson | Family Medicine | 451 Health Pkwy, Suite B, Paw Paw, MI 49079-8242 | 2005-06-23 |
| 1972132256 | Jean Marie Brosnan | Registered Nurse | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2020-04-07 |
| 1114570801 | Kinju Dudhia | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-22 |
| 1235781345 | Marlesa Maria Johnson | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-10 |
| 1447802459 | Miranda Novak | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-10 |
| 1336709500 | Daniel E Laird | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-06-19 |
| 1932625043 | Debra Lynn Koning | Social Worker | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2017-08-21 |
| 1720439979 | Kimberly Baker | Social Worker | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2016-06-29 |
| 1467858118 | Sara Bailey | Nurse Practitioner | 451 Health Pkwy, Suite A, Paw Paw, MI 49079-8242 | 2014-11-07 |
| 1053729269 | Todd Super | Pharmacist | 451 Health Pkwy, Paw Paw, MI 49079 | 2014-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1346775269 | Timothy Adli Kanaan | Counselor | 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 | 2017-04-28 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1942401047 | Jenny Adina Grunberg | Dentist | 54055 County Rd 653, Paw Paw, MI 49079 | 2007-05-29 |
| 1912058918 | David James Potts | Psychologist | 181 West Michigan Ave Suite 3, Mapleview Consultation Center P.c, Paw Paw, MI 49079 | 2007-01-16 |
| 1760438378 | Starhealth Multi-specialty Group, P.C. Pharmacy | Pharmacist | 451 Health Parkway, Paw Paw, MI 49079 | 2006-05-25 |
| 1528029568 | Jayantilal J Bathani | Pediatrics | 505 Hazen St, Ste 203, Paw Paw, MI 49079 | 2006-03-29 |
| 1548231202 | Gregory Cassidy | Physician Assistant | 125 N Kalamazoo St, #82, Paw Paw, MI 49079 | 2006-01-31 |
| 1649782418 | Amber Bemis | Occupational Therapy Assistant | 801 Hazen Street, Suite C, Paw Paw, MI 49079 | 2017-11-01 |
| 1073047122 | Theresa Arnold | Social Worker | 181 W Michigan Ave Ste 3, Paw Paw, MI 49079 | 2017-04-15 |
| Find all providers in zip 49079 | ||||
| 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 |
|---|---|---|---|---|
| 1679580104 | Haseeb A Khawaja | Internal Medicine | 451 Health Pkwy, Suite F, Paw Paw, MI 49079-8242 | 2006-08-01 |
| 1417922568 | Anthony W Miller | Internal Medicine | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2006-02-22 |
| 1710963970 | Naji M Khairallah | Internal Medicine | 451 Health Pkwy, Suite F, Paw Paw, MI 49079-8242 | 2005-12-20 |
| 1306829809 | Hugh M Sanchez | Internal Medicine | 404 Hazen St, Paw Paw, MI 49079-0178 | 2005-11-29 |
| 1730162256 | David B Peirce | Internal Medicine | 451 Health Pkwy, Suite F, Paw Paw, MI 49079-8242 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910687 | Berry Johnson Health Pllc | Internal Medicine | 30123 Rock Creek Dr, Southfield, MI 48076-5358 | 2020-10-24 |
| 1386243178 | Hoover Internal Medicine Pllc | Internal Medicine | 4067 Georgia St, Hamtramck, MI 48212 | 2020-10-22 |
| 1790399798 | Enhua Wang | Internal Medicine | 1215 E Michigan Ave Ste 500, Lansing, MI 48912-1811 | 2020-09-07 |
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 1568074375 | Mohammad Nadeemullah Pllc | Internal Medicine | 5400 Waldenhill Ct, Superior Twp, MI 48198-9654 | 2020-08-21 |
| 1356953723 | Eager Internal Medicine, Pllc | Internal Medicine | 720 N Lapeer Rd Ste 101, Lake Orion, MI 48362-4011 | 2020-08-18 |
| 1144838335 | Ranim Chamseddin | Internal Medicine | 3200 Five Points Dr Unit 110, Auburn Hills, MI 48326-2372 | 2020-07-14 |
| 1407474562 | Pravalika Rudraraju | Internal Medicine | 6245 Inkster Rd Dept Of, Garden City, MI 48135-4001 | 2020-07-06 |
| 1780200469 | Abed L Dabaja | Internal Medicine | 6245 Inkster Rd # Gme, Garden City, MI 48135-4001 | 2020-06-18 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
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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.