GREAT LAKES HEART & VASCULAR INSTITUTE, P.C. (NPI# 1205911047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205911047 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES HEART & VASCULAR INSTITUTE, P.C. |
| Practice Address |
3950 Hollywood Rd Suite 110 Saint Joseph MI 49085-9151 |
| Practice Telephone | 2699851000 |
| Practice Fax Number | 2699831627 |
| Mailing Telephone | 2699851000 |
| Mailing Fax Number | 2699831627 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2015-04-15 |
| Authorized Official Name | DR. THOMAS K POW (PRESIDENT) |
| Authorized Official Telephone | 2699851000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
TP054928 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3444708 | 05 | |
| MI | 4718520 | 05 | |
| MI | 4176414 | 05 | |
| MI | 4176450 | 05 | |
| MI | 4176497 | 05 | |
| MI | 4751365 | 05 |
| Street Address |
3950 HOLLYWOOD RD SUITE 110 |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-9151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689678021 | Lowell D Smith | Internal Medicine | 3950 Hollywood Rd, Ste 240, Saint Joseph, MI 49085-9151 | 2005-06-13 |
| 1144799982 | Philip Jasheway | Physical Therapist | 3950 Hollywood Rd, Saint Joseph, MI 49085-9159 | 2018-11-23 |
| 1235608274 | Sharon Elizabeth Roberts | Occupational Therapist | 3950 Hollywood Rd, Saint Joseph, MI 49085-9159 | 2018-11-20 |
| 1588113666 | Jessica R Schulte | Nurse Practitioner | 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085-9159 | 2016-09-29 |
| 1467804567 | Debora Tenter | Nurse Practitioner | 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085-9159 | 2016-07-13 |
| 1649622796 | Emily Schlitz Fix | Specialist/Technologist | 3950 Hollywood Rd, Suite 140, Saint Joseph, MI 49085-9159 | 2016-07-12 |
| 1336599901 | Kaitlyn Jackson | Specialist/Technologist | 3950 Hollywood Rd, Suite 140, Saint Joseph, MI 49085-9159 | 2016-06-15 |
| 1558725903 | Adam Thiesse | Specialist/Technologist | 3950 Hollywood Rd, Suite 140, Saint Joseph, MI 49085-9159 | 2016-04-12 |
| 1336514587 | Laurel Joy Yoder | Advanced Practice Midwife | 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085-9159 | 2015-12-14 |
| 1487021481 | Kathryn Jean Kern | Advanced Practice Midwife | 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085-9159 | 2015-08-25 |
| Find all providers in the same location | ||||
| 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 | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689996159 | Abraham Koshy | Internal Medicine | 3050 Bluffwood Pl, Saint Joseph, MI 49085-9347 | 2010-02-24 |
| 1184660938 | Mohan R Hindupur | Internal Medicine | 5514 Corporate Dr Ste 150, Saint Joseph, MO 64507-7752 | 2006-06-21 |
| 1356332258 | Cardiac Care Consultants Inc | Internal Medicine | 3925 Sherman Ave, Saint Joseph, MO 64506-3649 | 2005-10-31 |
| 1528054996 | Julian Jesus Nunez | Internal Medicine | 5514 Corporate Dr, Suite 150, Saint Joseph, MO 64507-7743 | 2005-09-21 |
| 1457354482 | Brian T Eller | Internal Medicine | 3078 Niles Rd, Saint Joseph, MI 49085-8608 | 2005-05-23 |
| 1013359173 | Sajjad Ahmad | Internal Medicine | 5514 Corporate Dr Ste 150, Saint Joseph, MO 64507-7763 | 2013-07-17 |
| 1366724437 | Lakeland Medical Practices | Internal Medicine | 1234 Napier Ave, Saint Joseph, MI 49085-2112 | 2011-09-15 |
| 1962644310 | Clarence Maurice Findley | Internal Medicine | 5514 Corporate Dr Ste 150, Saint Joseph, MO 64507-7763 | 2009-04-01 |
| 1134377435 | David K Rhine | Internal Medicine | 3950 Hollywood Rd Ste 110, Saint Joseph, MI 49085-9151 | 2008-08-29 |
| 1508051863 | My Heart Partners PC | Internal Medicine | 3078 Niles Rd, Saint Joseph, MI 49085-8608 | 2007-09-10 |
| Find all providers in SAINT JOSEPH | ||||
| 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.