GREAT LAKES RENAL NETWORK (NPI# 1295738144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295738144 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES RENAL NETWORK |
| Practice Address |
330 E Warwick Dr Alma MI 48801-1014 |
| Practice Telephone | 9894663300 |
| Practice Fax Number | 9894632540 |
| Mailing Telephone | 9894663300 |
| Mailing Fax Number | 9894632540 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GINA MATHIS (INSURANCE/MMAP COORDINATOR) |
| Authorized Official Telephone | 9894663300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ========= | MI | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 5170738 | 05 |
| Street Address |
330 E WARWICK DR |
| City | ALMA |
| State | MI |
| Zip Code | 48801-1014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053936161 | Kendra-marie Maddison Garcia | Student in an Organized Health Care Education/Training Program | 330 E Warwick Dr, Alma, MI 48801-1014 | 2020-06-15 |
| 1619592029 | Crystal Lee Holley | Family Medicine | 330 E Warwick Dr, Alma, MI 48801-1014 | 2020-06-11 |
| 1457976177 | Mary Thu Van Nguyen | Family Medicine | 330 E Warwick Dr, Alma, MI 48801-1014 | 2020-06-09 |
| 1972128619 | Jenna Bernson | Family Medicine | 330 E Warwick Dr, Alma, MI 48801-1014 | 2020-06-09 |
| 1659915148 | Jolene Bielicki | Social Worker | 330 E Warwick Dr, Alma, MI 48801-1014 | 2019-10-29 |
| 1073173563 | Kamil T Cieply | Student in an Organized Health Care Education/Training Program | 330 E Warwick Dr, Alma, MI 48801-1014 | 2019-06-17 |
| 1548820038 | Brandon J Armstrong | Student in an Organized Health Care Education/Training Program | 330 E Warwick Dr, Alma, MI 48801-1014 | 2019-06-17 |
| 1669032256 | Michael G Rodriguez | Student in an Organized Health Care Education/Training Program | 330 E Warwick Dr, Alma, MI 48801-1014 | 2019-06-17 |
| 1821658311 | Vanessa A Larouche | Student in an Organized Health Care Education/Training Program | 330 E Warwick Dr, Alma, MI 48801-1014 | 2019-06-17 |
| 1992297642 | James Alfred Lyons IIi | Family Medicine | 330 E Warwick Dr, Alma, MI 48801-1014 | 2018-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407365851 | Lisa Diane Ackerman | Social Worker | 608 Wright Ave., Alma, MI 48801 | 2017-09-28 |
| 1679082028 | Amelia Hope Kasper | Case Manager/Care Coordinator | 608 Wright Avenue, Alma, MI 48801 | 2017-09-28 |
| 1245687516 | Mickaela Perez | Technician, Other | 623 W Warwick Dr Ste 2, Alma, MI 48801 | 2016-05-17 |
| 1639443005 | Bobbi L Hall | Pharmacist | 2805 W Cheesman Rd, Alma, MI 48801 | 2012-03-02 |
| 1588998652 | Jonathan Michael Daniels | Physician Assistant | 311 E. Warwick Dr., Alma, MI 48801 | 2009-09-23 |
| 1659593937 | Foot Care Inc | Durable Medical Equipment & Medical Supplies | 115 E Superior Street, Alma, MI 48801 | 2007-05-03 |
| 1689716193 | Sara A Wassenaar | Dentist | 226 N State Street, Alma, MI 48801 | 2007-02-12 |
| 1760574883 | Midmichigan Medical Center- Gratiot | Internal Medicine | 300 E. Warwick Drive, Alma, MI 48801 | 2006-09-28 |
| 1437250305 | Michael Robert St Louis | Physician Assistant | 300 South Warwick Drive, Alma, MI 48801 | 2006-09-25 |
| 1215032099 | Talal Omar Samhan | Urology | 1465 Mary Court, Alma, MI 48801 | 2006-09-14 |
| Find all providers in zip 48801 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295064673 | Kali Aleece Pung | Specialist | 5475 Blue Heron Dr, Alma, MI 48801-9590 | 2009-12-15 |
| 1992971592 | Barbara Hope Bryant | Specialist | 412 Prospect Ave, Alma, MI 48801-1631 | 2008-05-02 |
| 1508877986 | Lou Ellen Hutcheson | Specialist | 1126 W 12th St, Alma, GA 31510-1814 | 2006-08-10 |
| 1366769457 | Gabor Kovacs Md, LLC | Specialist | 204 E 15th St, Alma, GA 31510-2908 | 2010-04-28 |
| 1144385527 | Peter B Tacia | Specialist | 1321 Pine Ave, Alma, MI 48801-1242 | 2006-12-26 |
| 1023196458 | Jeffrey Smith, Md PC | Specialist | 315 E Warwick Dr, #3, Alma, MI 48801-1083 | 2006-11-02 |
| 1700824612 | Pankaj Jandwani | Specialist | 300 E Warwick Dr, Alma, MI 48801-1014 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574118 | Gada Santos | Specialist | 10786 Pine St, Taylor, MI 48180-3440 | 2020-10-07 |
| 1750995361 | Advanced Spinal Reconstruction Pllc | Specialist | 972 Chesterfield Ave, Birmingham, MI 48009-1223 | 2020-09-01 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1235765827 | Magic Touch Salon | Specialist | 746 Burton St Se, Grand Rapids, MI 49507-3204 | 2020-03-16 |
| 1144865411 | Yasmeen Global Beauty Group | Specialist | 21701 W 11 Mile Rd Ste 7, Southfield, MI 48076-3713 | 2019-11-11 |
| 1255990552 | Kboose | Specialist | 3008 Juneberry Ave Se, Grand Rapids, MI 49508-1523 | 2019-06-10 |
| 1124685789 | Grooming Arts Lounge and Gallery | Specialist | 19520 Dorset St, Southfield, MI 48075-7112 | 2019-05-20 |
| 1144787326 | At Home Physician Management Group Co. | Specialist | 27440 Hoover Rd Ste C, Warren, MI 48093-7726 | 2019-02-25 |
| 1821561200 | Bailee J Moffitt | Specialist | 913 W Holmes Rd Unit 200, Lansing, MI 48910-0426 | 2019-01-08 |
| 1871064808 | Shanna E Cook | Specialist | 20843 Garden Ln, Ferndale, MI 48220-2217 | 2018-12-17 |
| Find all providers with the same taxonomy | ||||
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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.