LAKELAND NUCLEAR IMAGING, INC. (NPI# 1619933546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619933546 |
| Entity Type | Organization |
| Organization Name | LAKELAND NUCLEAR IMAGING, INC. |
| Practice Address |
122 Grant St Niles MI 49120-2281 |
| Mailing Address |
6720 Red Arrow Hwy Coloma MI 49038-9703 |
| Practice Telephone | 2696840295 |
| Practice Fax Number | 2696840189 |
| Mailing Telephone | 2696840295 |
| Mailing Fax Number | 2696840189 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2007-08-20 |
| Authorized Official Name | MR. DENNIS MACK (VICE PRESIDENT OF FACILITY & SUPPOR) |
| Authorized Official Telephone | 2696840259 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207UN0902X |
Nuclear Medicine Specialization: Nuclear Imaging & Therapy |
MI | Allopathic & Osteopathic Physicians |
| Street Address |
122 GRANT ST |
| City | NILES |
| State | MI |
| Zip Code | 49120-2281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407810047 | Sirimas Sirisuth | Internal Medicine | 122 Grant St, Niles, MI 49120-2281 | 2006-04-12 |
| 1649743535 | Amanda Marie Haines | Dental Hygienist | 122 Grant St, Niles, MI 49120-2281 | 2019-01-03 |
| 1447701008 | Lakeland Immediate Care Center | Clinic/Center | 122 Grant St, Niles, MI 49120-2281 | 2016-10-19 |
| 1629497631 | Maritza Iamalette Salvo-ale | Dentist | 122 Grant St, Niles, MI 49120-2281 | 2014-04-08 |
| 1699086744 | Lakeland Housecalls | General Practice | 122 Grant St, Niles, MI 49120-2281 | 2010-06-23 |
| 1871777227 | Four Flags Health Ventures,inc | Health Maintenance Organization | 122 Grant St, Niles, MI 49120-2281 | 2007-12-20 |
| 1922142561 | Joy Shen Ling | Internal Medicine | 122 Grant St, Niles, MI 49120-2281 | 2007-02-16 |
| 1417981549 | Barbara J Boyd | Internal Medicine | 122 Grant St, Niles, MI 49120-2281 | 2006-07-11 |
| 1568407930 | Niles Professional Services, Inc | Internal Medicine | 122 Grant St, Niles, MI 49120-2281 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285652 | The Caerus Group LLC | Clinic/Center | 732 S. 11th St #197, Niles, MI 49120 | 2018-11-27 |
| 1306316971 | Vicki L Yarbro | Physical Therapist | 6 Longmeadow Village Dr. Suite 3, Niles, MI 49120 | 2018-11-27 |
| 1063831469 | Aaron Joseph Lanning | Nurse Practitioner | 42 N Saint Joseph Ave Ste 300, Niles, MI 49120 | 2014-04-14 |
| 1740601186 | Terrianne Klaeren | Occupational Therapist | 1009 Almaugus Drive, Niles, MI 49120 | 2014-01-03 |
| 1124469366 | All Needs Senior Services, Inc. | Home Health | 1723 Pucker Street Dr, Suite A, Niles, MI 49120 | 2013-07-16 |
| 1902105034 | Nile Family Pharmacy LLC | Pharmacy | 70 E. State St., Niles, MI 49120 | 2011-03-15 |
| 1629240734 | Karen L Palmer | Counselor | 115 S St Joseph Ave, Niles, MI 49120 | 2008-03-28 |
| 1124218391 | Melissa A Longley | Social Worker | 333 N. Second Street, Suite 303, Niles, MI 49120 | 2007-07-25 |
| 1841410727 | Periza Zaninovic | Dentist | 123 Marmont Street, Niles, MI 49120 | 2007-04-26 |
| 1477629087 | Stephen Williams Tankersley | Dentist | 226 S Lincoln Ave, Niles, MI 49120 | 2006-11-27 |
| Find all providers in zip 49120 | ||||
| Taxonomy Code | 207UN0902X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Nuclear Medicine |
| Specialization | Nuclear Imaging & Therapy |
| A nuclear medicine physician who specializes in nuclear imaging and therapy. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Nuclear Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043388788 | Jose Antonio Bouffard | Nuclear Medicine | 261 Mack Ave, Room 215, Detroit, MI 48201-2417 | 2006-12-01 |
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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.