LAKE CITY PRIMARY CARE – NPI #1952896151
Clinic/Center

LAKE CITY PRIMARY CARE is an AHC clinic located in LAKE CITY, MI. NPPES has assigned the NPI number 1952896151 to LAKE CITY PRIMARY CARE on June 29, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LAKE CITY PRIMARY CARE” is a dba name, the actual legal business name for this organization is LAKE CITY PRIMARY CARE PC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QR1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rural Health

The NPI profile was previously updated about 4 years ago on Oct 03, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKE CITY PRIMARY CARE below.

NPI Profile for
LAKE CITY PRIMARY CARE PC

NPI Number
1952896151
Enumeration Date

(about 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LAKE CITY PRIMARY CARE PC
Doing Business As (dba): LAKE CITY PRIMARY CARE
Primary location
1866 S MOREY RD
LAKE CITY, MI 49651
Phone: (231) 908-8888 Fax: (833) 989-2153
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JASON BALL
OFFICE MANAGER
Phone: (231) 908-8888
Updated
Certification Date
Oct 03, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for LAKE CITY PRIMARY CARE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidMI238938
medicaidMIMI12315
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR1300X
- Clinic/Center / Rural Health (Primary)
261QP2300X
- Clinic/Center / Primary Care

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.