LARRY G WEST II (NPI# 1376156919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376156919 |
| Entity Type | Individual |
| Full Name | LARRY G WEST II |
| Credential | CPSS, CPRC |
| Practice Address |
1685 Baldwin Ave Ste 100 Pontiac MI 48340-1242 |
| Mailing Address |
117 University Place Dr Pontiac MI 48342-1890 |
| Practice Telephone | 2487063450 |
| Mailing Telephone | 2695892869 |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | MI | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497753719 | Larry Hugh West | Dentist | 1104 N El Dorado Place, Tucson, AZ 85715 | 2005-07-11 |
| 1619518024 | Larry West | Peer Specialist | 1321 S Fayette St, Saginaw, MI 48602-1447 | 2019-10-07 |
| 1972611754 | Larry Ketner West | Radiology | 911 South By Pass Road, Pikeville, KY 41501 | 2006-08-29 |
| 1891747382 | Larry D West | Nurse Anesthetist, Certified Registered | 988102 Nebraska Medical Ctr, Omaha, NE 68198-8102 | 2006-05-16 |
| Street Address |
1685 BALDWIN AVE STE 100 |
| City | PONTIAC |
| State | MI |
| Zip Code | 48340-1242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336689868 | Karen Bennett | Counselor | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1115 | 2017-03-02 |
| 1063013126 | Erick Post | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2020-11-05 |
| 1083228670 | Lauren Margaret Smith | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2020-09-01 |
| 1669096749 | Jordan Ramsey | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2020-06-03 |
| 1417595018 | Deshawnda Smith | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2019-12-13 |
| 1508400300 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2019-11-05 |
| 1790334670 | Sarah Westerman | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2019-09-04 |
| 1174179345 | Amber Janay Ivory | Case Manager/Care Coordinator | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2019-08-14 |
| 1265088470 | Jenetta Johnson | Social Worker | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1242 | 2019-08-13 |
| 1366002537 | Angela S Jurgensen | Social Worker | 1685 Baldwin Ave Ste 100, Pontiac, MI 48340-1115 | 2019-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851882799 | Maryan Luay Alkhoory | Dentist | 1620 N Perry St # 1, Pontiac, MI 48340 | 2018-05-26 |
| 1669907689 | Jeffrey D Bryant | Social Worker | 1841 N. Perry St, Pontiac, MI 48340 | 2017-04-27 |
| 1750822748 | Star Dental P.C. | Dentist | 775 Baldwin Rd, Suite C, Pontiac, MI 48340 | 2017-03-10 |
| 1609237965 | Stephanie Stephan | Dentist | 1590 Baldwin Ave, Auburn Hills, MI 48340 | 2016-03-15 |
| 1376908921 | Jump Start LLC Maternal Infant Health Program | Exclusive Provider Organization | 1086 Williamson Cir, Pontiac, MI 48340 | 2015-12-28 |
| 1417339532 | Ana Rodriguez | Point of Service | 612 Peacock Ave, Pontiac, MI 48340 | 2015-06-25 |
| 1104223544 | Tammy Fletcher | Registered Nurse | 1841 N Perry, Pontiac, MI 48340 | 2014-12-01 |
| 1558629238 | Oakland Integrated Healthcare Network | Clinic/Center | 816 Joslyn, Pontiac, MI 48340 | 2012-05-01 |
| 1447583398 | Dial A Doc Physicians PC | Pain Medicine | 28 N Saginaw, Chase Building, Pontiac, MI 48340 | 2009-09-10 |
| 1619199171 | Jann E. Trzeciak | Family Medicine | 1915 N Perrt Street, Pontiac, MI 48340 | 2007-05-03 |
| Find all providers in zip 48340 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093348906 | Robert Corey | Peer Specialist | 1841 N Perry St, Pontiac, MI 48340-2235 | 2020-02-19 |
| 1861025991 | Jordan Mark Shulman | Peer Specialist | 1841 N Perry St, Pontiac, MI 48340-2235 | 2020-02-17 |
| 1528579174 | Michael Lee Mcfarland | Peer Specialist | 1200 N Telegraph Rd Bldg 32, Pontiac, MI 48341-1032 | 2017-10-22 |
| 1003331232 | Melvin Victor Eckles | Peer Specialist | 1200 N Telegraph Rd, Pontiac, MI 48341-1032 | 2017-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026284 | Leah Mae Sindone | Peer Specialist | 22324 Derby Rd, Woodhaven, MI 48183-3700 | 2020-09-04 |
| 1992314728 | Willie Earl Feggins | Peer Specialist | 370 Country Club Rd, Holland, MI 49423-8303 | 2020-07-28 |
| 1831711613 | John Lee Williams Jr. | Peer Specialist | 24400 Schoolcraft, Redford, MI 48239-2633 | 2020-05-14 |
| 1568084861 | Zannie Roy Jackson Jr. | Peer Specialist | 36801 Ann Arbor Trl, Livonia, MI 48150-3422 | 2020-05-11 |
| 1417578865 | Veronica R Vasquez | Peer Specialist | 500 Hancock St # 48602, Saginaw, MI 48602-4224 | 2020-04-27 |
| 1235768680 | Matthew Milz | Peer Specialist | 145o S Lapeer Rd, Oxford, MI 48371-4982 | 2020-04-07 |
| 1558996132 | Camille Jewell Jackson | Peer Specialist | 8181 N Wayne Rd Apt S2147, Westland, MI 48185-3842 | 2020-03-04 |
| 1073146908 | James Laroach | Peer Specialist | 913 W. Homes Suite 200, Lansing, MI 48910 | 2020-02-19 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
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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.