MCLAREN GREATER LANSING (NPI# 1609266204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609266204 |
| Entity Type | Organization |
| Organization Name | MCLAREN GREATER LANSING |
| Practice Address |
5525 S Martin Luther King Jr Blvd Lansing MI 48911 |
| Mailing Address |
5525 S Martin Luther King Jr Blvd Lansing MI 48911-3546 |
| Practice Telephone | 5179133888 |
| Mailing Telephone | 5179133888 |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2018-08-02 |
| Authorized Official Name | MR. DALE THOMPSON (CFO) |
| Authorized Official Telephone | 5179757555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962808162 | Mclaren Greater Lansing | Family Medicine | 2479 Woodlake Cir, Suite 340, Okemos, MI 48864 | 2014-11-15 |
| 1235305673 | Mclaren Greater Lansing | Orthopaedic Surgery | 2815 S Pennyslvania, Suite 102, Lansing, MI 48910 | 2008-05-06 |
| 1558556332 | Mclaren Greater Lansing | Pediatrics | 401 W Greenlawn Ave Ste 110, Ingham Regional Medical Center, Lansing, MI 48910 | 2007-09-13 |
| 1316144157 | Mclaren Greater Lansing | Internal Medicine | 2510 Kerry St Ste 200, Lansing, MI 48912 | 2007-06-27 |
| 1831179837 | Mclaren Greater Lansing | Psychiatric Unit | 2727 S Penn Ave, Lansing, MI 48910-3488 | 2006-01-18 |
| 1104225168 | Mclaren Greater Lansing | Physician Assistant | 3937 Patient Care Way, #106, Lansing, MI 48911 | 2014-08-15 |
| 1992047252 | Mclaren Greater Lansing | Emergency Medicine | 6910 S Cedar St, Lansing, MI 48911 | 2013-03-25 |
| 1467704619 | Mclaren Greater Lansing | General Acute Care Hospital | 401 W Greenlawn Ave, Lansing, MI 48910 | 2012-10-12 |
| 1336491232 | Mclaren Greater Lansing | Physician Assistant | 2134 Hampton Pl, Okemos, MI 48864 | 2012-10-03 |
| 1316203094 | Mclaren Greater Lansing | Internal Medicine | 401 W Greenlawn Ave, Lansing, MI 48910 | 2012-04-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MCLAREN GREATER LANSING | 401 W Greenlawn Ave, Lansing, MI 48910-2819 |
| Street Address |
5525 S MARTIN LUTHER KING JR BLVD |
| City | LANSING |
| State | MI |
| Zip Code | 48911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083923841 | Candace Kay Wixson-johnson | Physician Assistant | 5525 S Martin Luther King Jr Blvd, Lansing, MI 48911-3546 | 2010-09-28 |
| 1023615135 | Tiffany Louise Gose | Physician Assistant | 5525 S Martin Luther King Jr Blvd, Lansing, MI 48911-3546 | 2020-10-02 |
| 1801365747 | Caitlan Lindsay Herron | Physician Assistant | 5525 S Martin Luther King Jr Blvd, Lansing, MI 48911-3546 | 2018-11-21 |
| 1124508460 | Andrea Schrecongost | Physician Assistant | 5525 S Martin Luther King Jr Blvd, Lansing, MI 48911 | 2018-08-16 |
| 1114411295 | Sandra Pollard | Nurse Practitioner | 5525 S Martin Luther King Jr Blvd, Lansing, MI 48911-3546 | 2018-06-21 |
| 1790224079 | Ifeyinwa Ajumobi | Physician Assistant | 5525 S Martin Luther King Jr Blvd, Lansing, MI 48911-3546 | 2017-02-20 |
| 1760861777 | Nyebol B Madut | Family Medicine | 5525 S Martin Luther King Jr Blvd, Lansing, MI 48911 | 2015-05-22 |
| 1245636885 | Southside Medical Center Inc | Internal Medicine | 5525 S Martin Luther King Jr Blvd, Lansing, MI 48911-3546 | 2014-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943603 | Promissa Personalized Care Services LLC | Assisted Living Facility | 200 E Edgewood Blvd, Lansing, MI 48911 | 2020-05-07 |
| 1457911877 | Zachary Todd Goldstein | Pediatrics | Cedar Pediatrics 5303 S. Cedar St, Suite 205, Lansing, MI 48911 | 2019-06-18 |
| 1447713946 | Fadi Nuseibeh | Pharmacist | 3955 Patient Care Drive, Pharmacy, Lansing, MI 48911 | 2019-04-11 |
| 1740704543 | Kyle Lardie | Dental Hygienist | Care Free Medical and Dental 5135 S Pennsylvania Ave, Lansing, MI 48911 | 2017-08-02 |
| 1124549845 | Joash Michael Charles | Behavior Technician | 3720 Richmond Street, Lansing, MI 48911 | 2017-07-03 |
| 1205212164 | Benjamin Curtis Neal | Dentist | 5601 S Cedar St., Lansing, MI 48911 | 2015-08-03 |
| 1376927608 | Heather Lamb | Home Health | 2919 Risdale St, Lansing, MI 48911 | 2015-07-16 |
| 1669861712 | Lucas James Evan Joseph Bila | Licensed Practical Nurse | 2204 S. Wadsworth Dr, Lansing, MI 48911 | 2015-01-13 |
| 1649695271 | Aaron James Hart | Occupational Therapist | 3960 Patient Care Dr Ste 117, Lansing, MI 48911 | 2014-02-18 |
| 1831465871 | Los Equipment Corporation | Dentist | 6810 S. Cedar St, Suite 5, Lansing, MI 48911 | 2012-03-23 |
| Find all providers in zip 48911 | ||||
| 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 |
|---|---|---|---|---|
| 1386265452 | Kyle Patrick Doran | Emergency Medicine | Sparrow Health System, 1215 E Michigan Avenue, Lansing, MI 48912 | 2020-04-30 |
| 1497248355 | Mont R Roberts | Emergency Medicine | 1215 E Michigan Ave # 3-post, Lansing, MI 48912-1811 | 2018-06-14 |
| 1972986511 | Denise Kohl | Emergency Medicine | 1215 East Michigan Ave., Sparrow Health Systems, Lansing, MI 48909 | 2015-07-01 |
| 1679735757 | Bradley Li | Emergency Medicine | 1210 E Michigan Ave, Lansing, MI 48912-1812 | 2008-06-30 |
| 1902089295 | Poomathi Sadhishkumar | Emergency Medicine | 1515 Lake Lansing Rd Ste C2, Lansing, MI 48912-3752 | 2007-12-10 |
| 1033308481 | Henry Carl Nygren | Emergency Medicine | 707 Prudden St, Apt 138, Lansing, MI 48906-5383 | 2007-10-22 |
| 1629282538 | Derek Steele | Emergency Medicine | 1215 East Michigan Avenue, Lansing, MI 48912 | 2007-05-09 |
| 1851414981 | Maxen Lane Baumgardner | Emergency Medicine | 1215 E. Michigan Ave, Sparrow Hospital, Attn Dr Baumgardner - Er, Lansing, MI 48912 | 2007-04-06 |
| 1922120567 | Stephanie Mann | Emergency Medicine | 2301 Belaire Dr, Lansing, MI 48911-1612 | 2007-04-04 |
| 1437176351 | Quickhealth - After Hours Medical Access Clinic, P.C. | Emergency Medicine | 740 N Waverly Rd, Lansing, MI 48917-2268 | 2006-07-16 |
| 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.