LAKESHORE COMMUNITY HOSPITAL INC (NPI# 1770863839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770863839 |
| Entity Type | Organization |
| Organization Name | LAKESHORE COMMUNITY HOSPITAL INC |
| Other Organization Name | LAKESHORE MEDICAL CENTER SHELBY |
| Practice Address |
71 Bevier St Shelby MI 49455-1209 |
| Practice Telephone | 2318612187 |
| Practice Fax Number | 2318615100 |
| Mailing Telephone | 2318612187 |
| Mailing Fax Number | 2318615100 |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2014-03-03 |
| Authorized Official Name | MRS. COLLEEN JOHNSON (OFFICE MANGER) |
| Authorized Official Telephone | 2317285910 |
| Authorized Official Credential | CMPE FABC |
| Is Organization Subpart | Y |
| Parent Organization Name | LAKESHORE COMMUNITY HOSPITAL INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Lakeshore Medical Center Shelby | Doing Business As Name - Organization |
| Street Address |
71 BEVIER ST |
| City | SHELBY |
| State | MI |
| Zip Code | 49455-1209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780675579 | Julie A Shellhouse | Family Medicine | 71 Bevier St, Shelby, MI 49455 | 2005-11-02 |
| 1184264327 | Daniel James Erickson | Physician Assistant | 71 Bevier St, Shelby, MI 49455-1209 | 2020-01-15 |
| 1982134482 | Christopher Charles Wagner | Family Medicine | 71 Bevier St, Shelby, MI 49455-1209 | 2017-06-16 |
| 1083160246 | Melvin Michael Vallette | Nurse Practitioner | 71 Bevier St, Shelby, MI 49455-1209 | 2016-08-28 |
| 1174904429 | Melissa J Wiegand | Nurse Practitioner | 71 Bevier St, Shelby, MI 49455-1209 | 2015-06-12 |
| 1588080030 | Mercy Health Partners | Clinic/Center | 71 Bevier St, Shelby, MI 49455-1209 | 2014-03-07 |
| 1700201712 | Mercy Health Partners | Surgery | 71 Bevier St, Shelby, MI 49455-1209 | 2014-02-27 |
| 1093144123 | Ann Marie Nienhuis | Nurse Practitioner | 71 Bevier St, Shelby, MI 49455-1209 | 2013-11-08 |
| 1467732537 | Lakeshore Community Hospital, Inc. | Family Medicine | 71 Bevier St, Shelby, MI 49455-1239 | 2011-08-22 |
| 1407099393 | Lakeshore Community Hospital, Inc | Clinic/Center | 71 Bevier St, Shelby, MI 49455-1239 | 2009-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013243369 | Rick R. Dayton, Dds PC | Dentist | 218 N. State St., Shelby, MI 49455 | 2009-10-21 |
| 1568499721 | Curtis G Glupker | Specialist | 71 Bevier Street, Shelby, MI 49455 | 2006-06-26 |
| 1356367783 | Oceana Home Medical Equipment Plus | Durable Medical Equipment & Medical Supplies | 169 N Michigan Ave, Shelby, MI 49455-1024 | 2006-07-15 |
| 1215014311 | Hometown Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 178 N Michigan Ave, Shelby, MI 49455-1028 | 2006-11-01 |
| 1912943663 | Susan K Radtke | Nurse Practitioner | 218 N Michigan Ave, Shelby, MI 49455-1028 | 2006-06-21 |
| 1912221771 | James W Pancy | Pharmacist | 178 N Michigan Ave, Shelby, MI 49455-1028 | 2010-03-23 |
| 1184840084 | Fred F Grice Jr. | Pharmacist | 178 N Michigan Ave, Shelby, MI 49455-1028 | 2007-04-18 |
| 1891818985 | Lori Ann Kleinjans | Pharmacist | 178 N Michigan Ave, Shelby, MI 49455-1028 | 2007-04-06 |
| 1598806242 | Rebecca Lynn Smith | Pharmacy Technician | 178 N Michigan Ave, Shelby, MI 49455-1028 | 2007-02-08 |
| 1518020585 | Hpcn | Family Medicine | 218 N Michigan Ave, Shelby, MI 49455-1028 | 2006-12-19 |
| Find all providers in zip 49455 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699753251 | Robert Laney IIi | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2006-01-04 |
| 1821469735 | Carolinas Physicians Network Inc | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2015-10-19 |
| 1700201712 | Mercy Health Partners | Surgery | 71 Bevier St, Shelby, MI 49455-1209 | 2014-02-27 |
| 1730449273 | Jiselle Marie Bock | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2012-05-17 |
| 1639464720 | Amanda Eckenrode | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2011-06-16 |
| 1538452610 | Tamera Cox | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2011-05-23 |
| 1508185604 | Stephen Von | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2010-05-28 |
| 1245498013 | Joseph Smith | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2008-05-29 |
| 1861580664 | Shelby Surgical Associates, Pa | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2006-10-10 |
| 1295781136 | James M Potts | Surgery | 200 W Grover St, Shelby, NC 28150-3708 | 2006-05-25 |
| Find all providers in SHELBY | ||||
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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.