GREAT LAKES MEDICAL, P,C, (NPI# 1750727129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750727129 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES MEDICAL, P,C, |
| Other Organization Name | GLADWIN URGENT CARE CENTER |
| Practice Address |
1277 E Cedar Ave Suite A Gladwin MI 48624-7004 |
| Practice Telephone | 9894261100 |
| Mailing Telephone | 9894261100 |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-07-15 |
| Authorized Official Name | DR. RICHARD WAYNE MACAULEY (OWNER) |
| Authorized Official Telephone | 5174492452 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
04411G | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE OF MICHIGAN ID | 04411G | 01 |
| Other Name | Type Code |
|---|---|
| GLADWIN URGENT CARE CENTER | Doing Business As Name - Organization |
| Street Address |
1277 E CEDAR AVE SUITE A |
| City | GLADWIN |
| State | MI |
| Zip Code | 48624-7004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770516221 | Midmichigan Home Health Services | Durable Medical Equipment & Medical Supplies | 1277 E Cedar Ave, Gladwin, MI 48624-7004 | 2006-07-08 |
| 1598106346 | Premierr Physical Therapy & Sports Medicine Clinic PC | Clinic/Center | 1277 E Cedar Ave, Gladwin, MI 48624-7004 | 2013-07-09 |
| 1609142439 | Gladwin Urgent Care PC | Clinic/Center | 1277 E Cedar Ave, Ste A, Gladwin, MI 48624-7004 | 2012-03-27 |
| 1598814071 | Bratton Clinic PC | Family Medicine | 1277 E Cedar Ave, Gladwin, MI 48624-7004 | 2007-01-10 |
| 1528175262 | Richard Dix Bratton Jr. | General Practice | 1277 E Cedar Ave, Gladwin, MI 48624-7004 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558889162 | Jacob Cameron Shell | Specialist/Technologist | 4403 Betty Lee Blvd, Gladwin, MI 48624 | 2017-09-03 |
| 1750704268 | Monica Maebel Weaver | Licensed Practical Nurse | 1426 North St. Street, Affordable Nursing Inc, Gladwin, MI 48624 | 2014-02-04 |
| 1417397407 | Richard Allen White | Registered Nurse | 655 East Cedar Avenue, Gladwin, MI 48624 | 2013-07-05 |
| 1023453040 | Amy Rebecca Brockschmidt | Counselor | Ten16 Recovery Network, 1302 Chatterton St. 2, Gladwin, MI 48624 | 2013-05-03 |
| 1447558341 | Erika Dianis | Psychologist | 655 E. Cedar Ave., Gladwin, MI 48624 | 2011-03-02 |
| 1457519456 | Bont & Medical Products Inc | Durable Medical Equipment & Medical Supplies | 895 N M18 Suite 2, Gladwin, MI 48624 | 2008-05-27 |
| 1346424454 | Regional Dialysis Services Inc | Clinic/Center | 673 Quarter Street, Gladwin, MI 48624 | 2007-12-26 |
| 1548476070 | Sambamurti . Srinivasan | Family Medicine | 602 Riverview Ct, Gladwin, MI 48624 | 2007-05-14 |
| 1295957850 | Midmichigan Visiting Nurse Association | Durable Medical Equipment & Medical Supplies | 1234 W Cedar Ave, Gladwin, MI 48624 | 2007-05-03 |
| 1710063755 | Janet Flynn | Registered Nurse | 1207 N Spring St, Gladwin, MI 48624 | 2006-10-31 |
| Find all providers in zip 48624 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609142439 | Gladwin Urgent Care PC | Clinic/Center | 1277 E Cedar Ave, Ste A, Gladwin, MI 48624-7004 | 2012-03-27 |
| 1093044067 | Midmichigan Medical Center Gladwin | Clinic/Center | 609 Quarter St, Gladwin, MI 48624-1941 | 2009-12-21 |
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| 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.