GREAT LAKES NEUROSURGICAL ASSOCIATES, PC (NPI# 1366590929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366590929 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES NEUROSURGICAL ASSOCIATES, PC |
| Practice Address |
414 Plymouth Ave Ne Grand Rapids MI 49505-6038 |
| Practice Telephone | 6164543465 |
| Mailing Telephone | 6164543465 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2011-11-04 |
| Authorized Official Name | MR. DENNIS M JOHNSTON (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 6164543465 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | LH029420 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NPI | 1225119027 | 01 |
| MI | NPI | 1659452472 | 01 |
| MI | NPI | 1770664583 | 01 |
| MI | NPI | 1245311059 | 01 |
| MI | NPI | 1497836282 | 01 |
| MI | NPI | 1326144049 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306366810 | Great Lakes Neurosurgical Associates, PC | Durable Medical Equipment & Medical Supplies | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2017-06-26 |
| Street Address |
414 PLYMOUTH AVE NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49505-6038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225119027 | John E. Stevenson | Neurological Surgery | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2006-10-18 |
| 1306366810 | Great Lakes Neurosurgical Associates, PC | Durable Medical Equipment & Medical Supplies | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2017-06-26 |
| 1932570975 | Neurosurgery Health Services Plc | Physician Assistant | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2015-10-16 |
| 1275791774 | Todd Douglas Vogel | Neurological Surgery | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2008-05-30 |
| 1639359029 | Lynn S Hedeman, Md, PC | Neurological Surgery | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2007-11-14 |
| 1467577817 | Marcia A Fitzgerald | Physician Assistant | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2007-03-21 |
| 1629193487 | Amy Ann Croff | Physician Assistant | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2007-03-20 |
| 1467577239 | Joanna M Polizzi | Physician Assistant | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2007-03-20 |
| 1841368685 | Bryan E Figueroa | Neurological Surgery | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2006-12-01 |
| 1245311059 | Joseph R. O'donnell | Neurological Surgery | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2006-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285276097 | Molly Beth Kerkstra | Home Health Aide | 1115 Ball Ave Nw, Grand Rapids, MI 49505 | 2019-10-14 |
| 1154849677 | Roshawn Nichol Whitley | Technician | 891 Maryland Ave, Grand Rapids, MI 49505 | 2017-09-05 |
| 1447778923 | Kelly Benzin-brinks | Social Worker | 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 | 2017-09-05 |
| 1033560404 | Taylor Nolan Boyd | Speech-Language Pathologist | 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 | 2016-06-28 |
| 1023465002 | Calvin Athy | Counselor | 1101 Ballave Ne, Grand Rapids, MI 49505 | 2016-05-19 |
| 1821456682 | Kelly Van Huisen | Counselor | 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 | 2016-02-08 |
| 1780051102 | Mark Squeteri | Social Worker | 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 | 2015-09-02 |
| 1346637337 | Shelby Fullington | Social Worker | 1011 Ball Ave Ne, Grand Rapids, MI 49505 | 2015-04-17 |
| 1457745325 | Lester Anderson II | Social Worker | 1115 Ball Ave, Grand Rapids, MI 49505 | 2015-03-27 |
| 1730570151 | Nicole Brown | Counselor | 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 | 2015-02-06 |
| Find all providers in zip 49505 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598945644 | Justin Charles Clark | Neurological Surgery | 414 Plymouth Ne, Grand Rapids, MI 49505-6041 | 2007-11-06 |
| 1639201353 | David Grant Carr | Neurological Surgery | 1707 Mont Rue Dr. Se, Grand Rapids, MI 49546 | 2007-03-09 |
| 1225119027 | John E. Stevenson | Neurological Surgery | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2006-10-18 |
| 1811965585 | Kent Neurological Associates PC | Neurological Surgery | 3200 Eagle Park Dr Ne Ste 108, Grand Rapids, MI 49525-7057 | 2006-03-09 |
| 1346215969 | Vicente Caldeira Gracias | Neurological Surgery | 445 Cherry St Se, Grand Rapids, MI 49503-4601 | 2006-02-17 |
| 1053386789 | Robert John Seledotis | Neurological Surgery | 847 Parchment Dr Se Ste 125, Grand Rapids, MI 49546-8623 | 2006-02-17 |
| 1427543487 | Leonard Herman Verhey | Neurological Surgery | 25 Michigan St Ne Ste 6100, Grand Rapids, MI 49503-2561 | 2018-06-22 |
| 1275055881 | Andres Felipe Restrepo Orozco | Neurological Surgery | 25 Michigan St Ne Ste 6100, Grand Rapids, MI 49503-2561 | 2017-07-14 |
| 1730634759 | Marian Michael Bercu | Neurological Surgery | 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503 | 2016-08-19 |
| 1831474618 | Artur Szymczak | Neurological Surgery | 35 Michigan St Ne, Suite 3003, Grand Rapids, MI 49503-2528 | 2011-10-12 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49505 |
Please comment or provide details below to improve the information on GREAT LAKES NEUROSURGICAL ASSOCIATES, PC.
| 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.