COUNTRY DOCTOR FAMILY PRACTICE PC (NPI# 1619093283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619093283 |
| Entity Type | Organization |
| Organization Name | COUNTRY DOCTOR FAMILY PRACTICE PC |
| Practice Address |
720 N Lapeer Rd Ste 101 Lake Orion MI 48362-4011 |
| Practice Telephone | 2486934500 |
| Practice Fax Number | 2486938170 |
| Mailing Telephone | 2486934500 |
| Mailing Fax Number | 2486938170 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHRISITNE SYPITKOWSKI (OWNER) |
| Authorized Official Telephone | 2486934500 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101010326 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 0156300595 | 01 |
| Street Address |
720 N LAPEER RD STE 101 |
| City | LAKE ORION |
| State | MI |
| Zip Code | 48362-4011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295275840 | Lori Tunney | Social Worker | 1175 Ridgeview Cir, Lake Orion, MI 48362 | 2017-03-01 |
| 1720300932 | Amanda Norrow | Occupational Therapist | 700 Knibbe Rd, Lake Orion, MI 48362 | 2010-02-16 |
| 1700061488 | Amy Lynn Santus | Counselor | 45 N Lapeer St, Lake Orion, MI 48362 | 2007-12-31 |
| 1992883193 | Dori Ann Freeland | Dentist | 436 South Broadway, Lake Orion, MI 48362 | 2006-11-02 |
| 1184647042 | Rocco Ciccone | Dentist | 792 South Lapear Rd., Lake Orion, MI 48362 | 2006-07-25 |
| 1922053685 | James J Bauer | Emergency Medicine | 785 North Lapeer Rd, Suite 100, Lake Orion, MI 48362 | 2006-05-23 |
| 1619453263 | Lauren Yearego | Counselor | 81 Indianwood Rd, Suite 2, Lake Orion, MI 48362 | 2018-07-17 |
| 1326013293 | Malgorzata Sobilo | Internal Medicine | 785 N Lapeer Rd, Lake Orion, MI 48362 | 2006-02-22 |
| 1588953335 | Diana Therese Kitzmiller | Psychologist | 55 Maumee Trl, Lake Orion, MI 48362-1221 | 2011-04-01 |
| 1215442652 | Brightstone Occupational Therapy Consultants, LLC | Occupational Therapist | 128 Menasha Trl, Lake Orion, MI 48362-1224 | 2017-12-07 |
| Find all providers in zip 48362 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306286893 | Joseph Gorz | Family Medicine | 1261 S Lapeer Rd Ste 202, Lake Orion, MI 48360-1419 | 2013-06-27 |
| 1013270362 | Norman Salem | Family Medicine | 1375 S Lapeer Rd Ste 106, Lake Orion, MI 48360-1421 | 2012-06-21 |
| 1508958737 | Vincenzo Guglielmetti | Family Medicine | 1375 S. Lapeer Rd., Ste. 106, Lake Orion, MI 48360 | 2006-09-28 |
| 1831290253 | Shree Devi Kilaru | Family Medicine | 1455 S Lapeer Rd Ste 100, Lake Orion, MI 48360-1468 | 2006-09-26 |
| 1982625976 | Gary P Holloway | Family Medicine | 46 W Shadbolt St, Lake Orion, MI 48362-3170 | 2006-07-22 |
| 1528001922 | Steven Paul Cogswell | Family Medicine | 4405 S Baldwin Rd Ste D, Lake Orion, MI 48359 | 2006-06-14 |
| 1972578854 | Pramote Tanswai | Family Medicine | 785 N Lapeer Rd, Lake Orion, MI 48362-4012 | 2006-02-22 |
| 1528033594 | Sandra A Golden | Family Medicine | 1455 S. Lapeer Rd, Ste D, Lake Orion, MI 48360 | 2006-02-22 |
| 1386635241 | Gita K Vora | Family Medicine | 1455 S Lapeer Rd, Suite 122, Lake Orion, MI 48360-1467 | 2005-10-31 |
| 1366097263 | Neighborhood Primary Care Pllc | Family Medicine | 1261 S Lapeer Rd Ste 202, Lake Orion, MI 48360-1419 | 2019-08-07 |
| Find all providers in LAKE ORION | ||||
| City | LAKE ORION |
| Zip Code | 48362 |
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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.