LAKELAND IMMEDIATE CARE CENTER (NPI# 1982677548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982677548 |
| Entity Type | Organization |
| Organization Name | LAKELAND IMMEDIATE CARE CENTER |
| Other Organization Name | CASSOPOLIS FAMILY CLINIC |
| Practice Address |
261 M 62 Cassopolis MI 49031-1034 |
| Practice Telephone | 2694453874 |
| Practice Fax Number | 2694452076 |
| Mailing Telephone | 2694453874 |
| Mailing Fax Number | 2694452076 |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2015-02-11 |
| Authorized Official Name | MARY GEEGAN MIDDLETON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2694453874 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 251J00000X | Nursing Care | Agencies | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | BCBS | 080A46198 | 01 |
| MI | 2890350 | 05 |
| Other Name | Type Code |
|---|---|
| Cassopolis Family Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407266687 | Lakeland Immediate Care Center | Clinic/Center | 22721 Diamond Cove St, Cassopolis, MI 49031-9711 | 2014-04-28 |
| 1144866310 | Lakeland Immediate Care Center | Pharmacy | 1951 Oak St, Niles, MI 49120-3738 | 2019-11-22 |
| 1447701008 | Lakeland Immediate Care Center | Clinic/Center | 122 Grant St, Niles, MI 49120-2281 | 2016-10-19 |
| 1811389570 | Lakeland Immediate Care Center | Obstetrics & Gynecology | 60 N Saint Joseph Ave, Suite B, Niles, MI 49120-2296 | 2015-03-04 |
| 1114328614 | Lakeland Immediate Care Center | Pharmacy | 261 M 62, Cassopolis, MI 49031-1034 | 2014-09-16 |
| 1972913150 | Lakeland Immediate Care Center | Clinic/Center | 60 N Saint Joseph Ave, Niles, MI 49120-2296 | 2014-04-28 |
| 1760802912 | Lakeland Immediate Care Center | Clinic/Center | 24 N Saint Joseph Ave, Suite G, Niles, MI 49120-2263 | 2014-04-25 |
| Street Address |
261 M 62 |
| City | CASSOPOLIS |
| State | MI |
| Zip Code | 49031-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831171768 | Ann E Traynor | Internal Medicine | 261 M 62, Cassopolis, MI 49031-1034 | 2005-11-16 |
| 1073075834 | Joni K Hodge | Dental Hygienist | 261 M 62, Cassopolis, MI 49031-1034 | 2019-04-02 |
| 1386197325 | Andrew Zaremba | Dentist | 261 M 62, Cassopolis, MI 49031-1034 | 2016-07-26 |
| 1922457860 | Jody Murmu | Nurse Practitioner | 261 M 62, Cassopolis, MI 49031-1034 | 2016-06-10 |
| 1437507464 | Neil Bowman | Registered Nurse | 261 M 62, Cassopolis, MI 49031-1034 | 2016-05-31 |
| 1730552050 | Heather Stack | Dental Hygienist | 261 M 62, Cassopolis, MI 49031-1034 | 2015-11-09 |
| 1700257151 | Mphasa Mwanza | Nurse Practitioner | 261 M 62, Cassopolis, MI 49031-1034 | 2015-10-12 |
| 1134513377 | Andre Smyth | Family Medicine | 261 M 62, Cassopolis, MI 49031-1034 | 2015-03-25 |
| 1114328614 | Lakeland Immediate Care Center | Pharmacy | 261 M 62, Cassopolis, MI 49031-1034 | 2014-09-16 |
| 1689872913 | Mitchell B. Hannafius | Social Worker | 261 M 62, Cassopolis, MI 49031-1034 | 2007-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891241196 | Mike Hewlett | Dentist | 261 M-62, Cassopolis, MI 49031 | 2016-08-28 |
| 1093802902 | Van Buren/cass District Health Department | Public Health or Welfare | 201 M-62 North, Cassopolis, MI 49031 | 2006-10-10 |
| 1992804637 | Jennifer Lee Deer | Social Worker | 960 State St, Cassopolis, MI 49031 | 2006-09-21 |
| 1174639728 | Lewis Cass Intermediate School District | Local Education Agency (LEA) | 61682 Dailey Road, Cassopolis, MI 49031 | 2006-08-23 |
| 1841293230 | Kathy Joy Emans | Social Worker | 960 E. State, Cassopolis, MI 49031 | 2005-05-31 |
| 1861981268 | Leslie Lakeman | Physical Therapist | 23770 Hospital St, Cassopolis, MI 49031 | 2018-05-02 |
| 1922554633 | Maureen Raj | Counselor | 261 M-62, Cassopolis, MI 49031 | 2016-09-01 |
| 1326047002 | John H. Foster | Family Medicine | 109 School St, Cassopolis, MI 49031-1023 | 2005-07-15 |
| 1639594054 | Crystal Dawn Payton | Nurse Practitioner | 109 School St, Cassopolis, MI 49031-1023 | 2014-02-21 |
| 1336358159 | Van Buren Cass District Public Health Department | Public Health or Welfare | 201 M 62, Cassopolis, MI 49031-1034 | 2007-05-21 |
| Find all providers in zip 49031 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407266687 | Lakeland Immediate Care Center | Clinic/Center | 22721 Diamond Cove St, Cassopolis, MI 49031-9711 | 2014-04-28 |
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| Find all providers with the same taxonomy | ||||
| City | CASSOPOLIS |
| Zip Code | 49031 |
Please comment or provide details below to improve the information on LAKELAND IMMEDIATE CARE CENTER.
| 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.