LAKE COUNTRY UROLOGY CLINIC, PLLC (NPI# 1528190303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528190303 |
| Entity Type | Organization |
| Organization Name | LAKE COUNTRY UROLOGY CLINIC, PLLC |
| Other Organization Name | LAKE COUNTRY HEALTH ALLIANCE |
| Practice Address |
420 W High St Dowagiac MI 49047-1943 |
| Mailing Address |
17 Vinewood Ave Sturgis MI 49091-2375 |
| Practice Telephone | 2696514708 |
| Mailing Telephone | 2696514708 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-10-17 |
| Authorized Official Name | MARIANO L ORCA (PRESIDENT, PLLC) |
| Authorized Official Telephone | 2696514708 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| LAKE COUNTRY HEALTH ALLIANCE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972677870 | Lake Country Urology Clinic, Pllc | Urology | 17 Vinewood Ave, Sturgis, MI 49091-2375 | 2006-11-20 |
| 1952433732 | Lake Country Urology Clinic, Pllc | Urology | 711 S Health Pkwy, Three Rivers, MI 49093-9387 | 2007-03-09 |
| 1154453926 | Lake Country Urology Clinic, Pllc | Urology | 235 E Chicago St, Coldwater, MI 49036-1783 | 2007-03-09 |
| Street Address |
420 W HIGH ST |
| City | DOWAGIAC |
| State | MI |
| Zip Code | 49047-1943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295715878 | Charlene Howland | Nurse Anesthetist, Certified Registered | 420 W High St, Dowagiac, MI 49047-1943 | 2006-01-19 |
| 1437654324 | Gregory N Otto | Physical Therapist | 420 W High St, Dowagiac, MI 49047-1943 | 2018-03-24 |
| 1467956482 | Bertha Naomi Prahoveanu | Physical Therapist | 420 W High St, Dowagiac, MI 49047-1996 | 2018-03-23 |
| 1043714058 | Erica Michelle Vantuyl | Physical Therapist | 420 W High St, Dowagiac, MI 49047-1943 | 2018-03-23 |
| 1366838088 | Ascension Borgess Lee Hospital | Clinic/Center | 420 W High St, Dowagiac, MI 49047-1943 | 2015-04-09 |
| 1447502059 | Borgess Lee Memorial Hospital | Emergency Medicine | 420 W High St, Dowagiac, MI 49047-1943 | 2012-10-05 |
| 1447516869 | D&a Dissolving, Inc. | Clinic/Center | 420 W High St, Dowagiac, MI 49047-1943 | 2012-04-10 |
| 1821236324 | Ascension Borgess Lee Hospital | Clinic/Center | 420 W High St, Dowagiac, MI 49047-1943 | 2009-01-22 |
| 1457504243 | Ascension Borgess Lee Hospital | General Acute Care Hospital | 420 W High St, Dowagiac, MI 49047-1943 | 2008-10-24 |
| 1366691198 | Melissa K Schiffli | Social Worker | 420 W High St, Borgess Lee Memorial, Dowagiac, MI 49047-1943 | 2008-09-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497149124 | Karianne Ely | Specialist/Technologist | 92407 Center Dr, Dowagaic, MI 49047 | 2015-03-19 |
| 1669786257 | Pokagon Band of Potawatomi Indians | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 32652 Kno Dr, Dowagiac, MI 49047 | 2010-08-06 |
| 1851619332 | Paddington Healthcare of Michigan LLC | Skilled Nursing Facility | 55432 Colby Street, Dowagiac, MI 49047 | 2010-05-10 |
| 1649502592 | Dowagiac Surgery PC | Surgery | 106 South Lowe St, Dowagiac, MI 49047 | 2010-02-03 |
| 1134336605 | Stephanie Lynn Munson | Specialist/Technologist | 29650 M62 W, Dowagiac, MI 49047 | 2007-05-16 |
| 1689705444 | Michael R Dewitt | Pharmacist | 56151 M51 South, Dowagiac, MI 49047 | 2007-03-07 |
| 1225185705 | Pokagon Band of Potawatomi Indians | Dietitian, Registered | 32652 Kno, Dowagiac, MI 49047 | 2007-01-05 |
| 1588726517 | Lee Memorial Hospital Corporation | Clinic/Center | 67892 M-152, Dowagiac, MI 49047 | 2006-12-15 |
| 1326156332 | Megan Lynne Foote | Pharmacist | 56151 M-51, Dowagiac, MI 49047 | 2006-08-29 |
| 1467567057 | Jonathan Wade Gillesby | Dentist | 530 Riverside Drive, Dowagiac, MI 49047 | 2006-08-21 |
| Find all providers in zip 49047 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1396235610 | Munson Medical Center | Urology | 405 N Division Rd Ste 2, Petoskey, MI 49770-9046 | 2018-05-11 |
| 1770072498 | Bellin Health Iron Mountain Inc | Urology | 1005 S Hemlock St Ste B, Iron Mountain, MI 49801-3854 | 2018-05-08 |
| 1205215621 | Alexander David Tapper | Urology | 44200 Woodward Ave Ste 207, Pontiac, MI 48341-5045 | 2015-05-19 |
| 1912324211 | Boston Medical Group, P.C. | Urology | 24901 Northwestern Hwy., Suite 615, Southfield, MI 48075 | 2014-03-25 |
| 1548600984 | Katie Marie Rosen | Urology | 19991 Hall Rd Ste 201, Macomb, MI 48044 | 2013-06-30 |
| 1609213636 | Arya Khatiwoda | Urology | 2900 Hannah Blvd Ste 104, East Lansing, MI 48823-5380 | 2013-05-31 |
| 1003179730 | Kalen Jacob Rimar | Urology | 130 Town Center Dr Ste 101, Troy, MI 48084 | 2012-06-18 |
| 1780955294 | Harry Nicholas Kotsis | Urology | 265 Touraine Rd, Grosse Pointe Farms, MI 48236-3308 | 2012-01-16 |
| 1750678264 | Michael Kozminski | Urology | 245 Cherry St Se Ste 202, Grand Rapids, MI 49503-4607 | 2011-07-05 |
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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.