GREAT LAKES PROSTHETICS AND BUSCH DANIEL J MEMBER (NPI# 1316245343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316245343 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES PROSTHETICS AND BUSCH DANIEL J MEMBER |
| Other Organization Name | GREAT LAKES PROSTHETICS AND ORTHOTICS LLC |
| Practice Address |
5315 Elliott Dr Suite 104 Ypsilanti MI 48197-8634 |
| Practice Telephone | 7345285200 |
| Practice Fax Number | 7345285260 |
| Mailing Telephone | 7345285200 |
| Mailing Fax Number | 7345285260 |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-04-01 |
| Authorized Official Name | MR. CHRISTOPHER JAMES FAIRMAN (CO-OWNER) |
| Authorized Official Telephone | 7345285200 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| Great Lakes Prosthetics and Orthotics LLC | Other Name - Individual/Organization |
| Street Address |
5315 ELLIOTT DR SUITE 104 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-8634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760483010 | Robert A Young | Orthopaedic Surgery | 5315 Elliott Dr, Suite 301, Ypsilanti, MI 48197-8634 | 2005-08-09 |
| 1710492756 | St Joseph Mercy Hospital | Clinic/Center | 5315 Elliott Dr, Ypsilanti, MI 48197-8634 | 2017-12-13 |
| 1578075420 | Christopher Hagedon | Physical Therapist | 5315 Elliott Dr, Ypsilanti, MI 48197-8634 | 2017-11-01 |
| 1245771583 | Catherine Mcauley Health Services Corp | Specialist | 5315 Elliott Dr, Suite 102, Ypsilanti, MI 48197-8634 | 2017-03-20 |
| 1447629662 | Johnathan Ogar | Physician Assistant | 5315 Elliott Dr, Suite 102, Ypsilanti, MI 48197-8634 | 2015-09-17 |
| 1992109904 | Iha Health Services Corp. | Orthopaedic Surgery | 5315 Elliott Dr, Suite 202, Ypsilanti, MI 48197-8634 | 2014-10-20 |
| 1225467814 | Chelsea Professional Services | Orthopaedic Surgery | 5315 Elliott Dr, Suite 301, Ypsilanti, MI 48197-8634 | 2013-11-05 |
| 1801223607 | Saline Medical Office | Orthopaedic Surgery | 5315 Elliott Dr, Suite 304, Ypsilanti, MI 48197-8634 | 2013-10-11 |
| 1003189648 | Kurt J Hiester | Physician Assistant | 5315 Elliott Dr, Ste 102, Ypsilanti, MI 48197-8634 | 2012-02-13 |
| 1770886640 | Linda Lavastida-kapp | Physical Therapist | 5315 Elliott Dr, Ste 202, Ypsilanti, MI 48197-8634 | 2010-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093998585 | Community Orthopedic Surgery PC | Prosthetic/Orthotic Supplier | 5315 Elliott Dr Ste 202, Ypsilanti, MI 48197-8634 | 2007-12-07 |
| 1063778884 | Sole Source LLC Your Diabetic Shoe Store | Prosthetic/Orthotic Supplier | 50 N Huron St, Ypsilanti, MI 48197-2608 | 2012-04-05 |
| 1366613382 | Michigan Orthopedic Services LLC | Prosthetic/Orthotic Supplier | 5315 Elliott Drive, Ste 104, Ypsilanti, MI 48197-8634 | 2008-03-18 |
| 1518148741 | Community Orthopedic Surgery PC | Prosthetic/Orthotic Supplier | 5315 Elliott Dr, Suite 202, Ypsilanti, MI 48197-8634 | 2007-11-15 |
| 1407963325 | Great Lakes Prosthetics & Orthotics, Inc | Prosthetic/Orthotic Supplier | 5315 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8634 | 2006-08-24 |
| 1386694974 | Kochs Orthotic Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 5315 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8634 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578178026 | Teter Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 106 S Greenville West Dr Ste 3, Greenville, MI 48838-3504 | 2020-09-11 |
| 1508474297 | Brandy Denise Smith-bounds | Prosthetic/Orthotic Supplier | 41660 Huntington Dr, Sterling Heights, MI 48313-3128 | 2020-07-19 |
| 1912537705 | The W Beauty and Barber Lounge | Prosthetic/Orthotic Supplier | 18718 Grand River Ave, Detroit, MI 48223-2215 | 2020-01-21 |
| 1710520507 | Michigan Surgery Specialists, P.C. | Prosthetic/Orthotic Supplier | 19725 Allen Rd Ste B, Brownstown Twp, MI 48183-1090 | 2019-10-24 |
| 1952962003 | Best Choice Senior Services, Inc | Prosthetic/Orthotic Supplier | 27177 Lahser Rd Ste 206, Southfield, MI 48034-8468 | 2019-06-27 |
| 1124686704 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 2550 Niles Rd Ste 1, Saint Joseph, MI 49085-3270 | 2019-05-30 |
| 1972066348 | Jan J Stokosa | Prosthetic/Orthotic Supplier | 2145 University Park Drive, Suite 100, Okemos, MI 48864 | 2019-04-11 |
| 1306304670 | Ddp Mobility and Safety Medical Equipment | Prosthetic/Orthotic Supplier | 27258 Cecile St, Dearborn Heights, MI 48127-3393 | 2019-03-06 |
| 1538626221 | Crossroads Orthotics & Consultation, Inc. | Prosthetic/Orthotic Supplier | 4025 Holt Rd Ste 110, Holt, MI 48842-6019 | 2019-02-28 |
| 1952886343 | Confidence Beyond Hair Loss | Prosthetic/Orthotic Supplier | 14830 Lakeshore Dr, Grand Haven, MI 49417-8636 | 2018-10-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on GREAT LAKES PROSTHETICS AND BUSCH DANIEL J MEMBER.
| 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.