CRISTO REY COMMUNITY CENTER (NPI# 1407800931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407800931 |
| Entity Type | Organization |
| Organization Name | CRISTO REY COMMUNITY CENTER |
| Practice Address |
1717 N High St Lansing MI 48906-4529 |
| Practice Telephone | 5173711700 |
| Practice Fax Number | 5173714245 |
| Mailing Telephone | 5173711700 |
| Mailing Fax Number | 5173714245 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-06-25 |
| Authorized Official Name | DR. PETER H COOKE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5173711700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | SL037010 | MI | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | PC049423 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3148943 | 05 | |
| MI | BCBS COOKE | 010C362090 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700901964 | Cristo Rey Community Center | Counselor | 1717 N High St, Lansing, MI 48906-4529 | 2007-03-20 |
| Street Address |
1717 N HIGH ST |
| City | LANSING |
| State | MI |
| Zip Code | 48906-4529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861009250 | Jessi Marie De La Cruz | Social Worker | 1717 N High St, Lansing, MI 48906-4597 | 2020-09-29 |
| 1215541313 | Beth Betten | Nurse Practitioner | 1717 N High St, Lansing, MI 48906-4529 | 2020-09-04 |
| 1194362236 | Rosa Castanon | Social Worker | 1717 N High St, Lansing, MI 48906-4597 | 2019-12-09 |
| 1851946057 | Gabrielle Vanwert | Case Manager/Care Coordinator | 1717 N High St, Lansing, MI 48906-4529 | 2019-08-05 |
| 1265994206 | Jessica Elizabeth Gordon | Counselor | 1717 N High St, Lansing, MI 48906-4597 | 2019-04-01 |
| 1306329313 | Rebecca Lynn Jackson | Counselor | 1717 N High St, Lansing, MI 48906-4529 | 2018-09-14 |
| 1396246880 | Heather Dahl | Case Manager/Care Coordinator | 1717 N High St, Lansing, MI 48906-4529 | 2018-02-21 |
| 1881102945 | Nicole Anne Holbrook | Counselor | 1717 N High St, Lansing, MI 48906-4529 | 2018-01-11 |
| 1528575974 | Kimberle Lynn Kwasnick | Marriage & Family Therapist | 1717 N High St, Lansing, MI 48906-4529 | 2018-01-08 |
| 1851777478 | Allison Franck | Social Worker | 1717 N High St, Rm 216, Lansing, MI 48906-4529 | 2015-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487126595 | Mallory Godin | Counselor | 14509 Boichot Rd, Lansing, MI 48906 | 2018-12-31 |
| 1184133654 | Derrick Ray Lewis II | Technician | 3209 Trillium Drive, Lansing, MI 48906 | 2017-09-27 |
| 1497184329 | Michelle Ann Munson-mccorry | Registered Nurse | 1108 Ballard, Lansing, MI 48906 | 2013-11-01 |
| 1497190961 | Guided Choices | Registered Nurse | 2812 N Martin Luther King Jr Blvd, Lansing, MI 48906 | 2013-05-09 |
| 1154665677 | Agape Chiro Med of Michigan, LLC | Chiropractor | 1029 E Saginaw Street, Lansing, MI 48906 | 2012-11-21 |
| 1306143771 | Wayne County Physical Therapy, LLC | Clinic/Center | 1029 E Saginaw, Lansing, MI 48906 | 2011-02-22 |
| 1083877344 | Sabrina Diane Dinkha | Pediatrics | 13750 S Sedona Parkway, Suite 2, Lansing, MI 48906 | 2008-07-08 |
| 1922173103 | Linda Sue Hughes | Nurse Practitioner | 1717 N. High Street, Lansing, MI 48906 | 2006-11-22 |
| 1124102207 | Airway Oxygen Inc | Durable Medical Equipment & Medical Supplies | 1035 Mak-tech Drive, Lansing, MI 48906 | 2006-10-25 |
| 1689777252 | Plastic & Cosmetic Surgeons PC | Plastic Surgery | 1219 East Saginaw Street, Lansing, MI 48906 | 2006-09-07 |
| Find all providers in zip 48906 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760805352 | Stephanie Grondahl | General Practice | 1200 E Michigan Ave Ste 460, Lansing, MI 48912-1897 | 2014-02-02 |
| 1730235862 | John Crisler | General Practice | 320 W Ottawa St, Lansing, MI 48933-1590 | 2007-01-25 |
| 1093800716 | Arden B Andersen | General Practice | 712 1st Ter Ste 205, Lansing, KS 66043-1735 | 2006-10-04 |
| 1699874701 | Medical Ambulatory Services for Health PC | General Practice | 1107 E Miller Rd, Lansing, MI 48911-5312 | 2006-09-22 |
| 1285733378 | Medical Ambulatory Services for Health PC | General Practice | 6130 W Saginaw Hwy, Lansing, MI 48917-2465 | 2006-09-22 |
| 1477594786 | Margaret Ijeoma Aguwa | General Practice | 2929 Coventing Court, Lansing, MI 48912 | 2006-06-09 |
| 1659339570 | Leland Robert Mcelmurry | General Practice | 1601 E Michigan Ave, Lansing, MI 48912 | 2006-05-02 |
| 1023005659 | Harold Franklin Roth | General Practice | 1627 Lake Lansing Rd, Suite 200, Lansing, MI 48912-3788 | 2005-09-29 |
| 1629410725 | Thomas W Keaveney | General Practice | 1322 E Michigan Ave, Suite 101, Lansing, MI 48912-2199 | 2013-07-18 |
| 1861639791 | John Michael Clarkson | General Practice | 1322 E Michigan Ave, Suite 101, Lansing, MI 48912-2199 | 2009-01-14 |
| Find all providers in LANSING | ||||
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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.