LAKELAND MEDICAL PRACTICES (NPI# 1417324393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417324393 |
| Entity Type | Organization |
| Organization Name | LAKELAND MEDICAL PRACTICES |
| Other Organization Name | STONEGATE PLACTIC SURGERY |
| Practice Address |
3901 Stonegate Park Suite 300 Saint Joseph MI 49085-9137 |
| Practice Telephone | 2695566000 |
| Practice Fax Number | 2695566020 |
| Mailing Telephone | 2695566000 |
| Mailing Fax Number | 2695566020 |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2015-08-27 |
| Authorized Official Name | WARREN WHITE JR. (VICE PRESIDENT PHYSICIAN SERVICES) |
| Authorized Official Telephone | 2699838304 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
4301056980 | MI | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Stonegate Plactic Surgery | 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 |
| 1174038392 | Lakeland Medical Practices | Psychiatry & Neurology | 3950 Hollywood Rd Ste 230, Saint Joseph, MI 49085-9158 | 2017-12-11 |
| 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 |
| Street Address |
3901 STONEGATE PARK SUITE 300 |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-9137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013914241 | Samuel Ernest Logan | Specialist | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2005-07-01 |
| 1922557347 | Lakeland Medical Practices | Dermatology | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2016-09-27 |
| 1255525697 | American Limb & Orthopedic Co. | Prosthetic/Orthotic Supplier | 3901 Stonegate Park, Suite 200, Saint Joseph, MI 49085-9137 | 2007-08-29 |
| 1538370135 | Gordon Sanghi Won | Dentist | 3901 Stonegate Park, Ste 100, Saint Joseph, MI 49085-9137 | 2007-05-24 |
| 1558570580 | Karen Lynne Powers | Plastic Surgery | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2007-05-22 |
| 1568504397 | Riddhi Jay Shah | Dermatology | 3901 Stonegate Park, Suite 300, Saint Joseph, MI 49085-9137 | 2007-02-12 |
| 1578655270 | Christina Diane Pareigis | Physical Medicine & Rehabilitation | 3901 Stonegate Park, Suite #500, Saint Joseph, MI 49085-9137 | 2006-09-29 |
| 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 | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154527190 | Jonathan Amspacher | Surgery | 5204 N Belt Hwy, Saint Joseph, MO 64506-1211 | 2007-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629528765 | Paragon Health, P.C. | Surgery | 8175 Creekside Dr Ste 100, Portage, MI 49024-5370 | 2016-10-13 |
| 1487091989 | Trevor K O'brien | Surgery | 4110 Copper Ridge Dr Ste 242, Traverse City, MI 49684-6721 | 2013-05-24 |
| 1851689525 | Robert Moore Oneal | Surgery | 501 Onondaga St, Ann Arbor, MI 48104-2606 | 2011-07-15 |
| 1902072952 | Michigan Cosmetic & Reconstructive Surgery Pllc | Surgery | 29110 Inkster Rd, Ste 250, Southfield, MI 48034-1098 | 2008-04-30 |
| 1518184175 | Halil Ibrahim Canter | Surgery | 16001 West 9 Mile Rd., 3 Fl Fischer Ctr Providence Hosp. Craniofacial Inst., Southfield, MI 48075 | 2007-04-18 |
| 1285756148 | Andrea Emma Van Pelt | Surgery | 4070 Lake Drive Se, Suite 202, Grand Rapids, MI 49546 | 2007-04-04 |
| 1083741367 | Kenneth Wolf | Surgery | 1990 Union Lake Rd Ste 200, Commerce Township, MI 48382-2200 | 2007-02-27 |
| 1972630259 | Lauran Bryan | Surgery | 26711 Woodward Ave Ste Ll1, Huntington Woods, MI 48070-1370 | 2007-02-27 |
| 1689761439 | John J Iacobucci | Surgery | 221 Michigan St Ne Ste 300, Grand Rapids, MI 49503-2537 | 2006-10-05 |
| 1710996319 | Ewa D Komorowska-timek | Surgery | 3855 Burton St Se Ste A, Grand Rapids, MI 49546-5816 | 2006-08-05 |
| 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.