| Lake City Primary Care | |
|
1866 S Morey Rd Lake City MI 49651 | |
| (231) 908-8888 | |
| (833) 989-2153 |
| Full Name | Lake City Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1866 S Morey Rd, Lake City, Michigan |
| Authorized Official Name and Position | Jason Ball (OFFICE MANAGER) |
| Authorized Official Contact | 2319088888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake City Primary Care 1866 S Morey Rd Lake City MI 49651-9190 Ph: (231) 830-7282 | Lake City Primary Care 1866 S Morey Rd Lake City MI 49651 Ph: (231) 908-8888 |
| NPI Number | 1952896151 |
|---|---|
| Provider Enumeration Date | 06/29/2018 |
| Last Update Date | 10/03/2022 |
| Medicare PECOS PAC ID | 7911242433 |
|---|---|
| Medicare Enrollment ID | O20190102001466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952896151 | NPI | - | NPPES |
| 238938 | Medicaid | MI | |
| MI12315 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Gregory Lambourne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598775850 PECOS PAC ID: 0143218339 Enrollment ID: I20040505000971 |
| Provider Name | Christopher M Donzell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780932137 PECOS PAC ID: 5092964585 Enrollment ID: I20120926000636 |
| Provider Name | Gina M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336626431 PECOS PAC ID: 8527312099 Enrollment ID: I20181120000659 |
| Provider Name | Ashley Rozeveld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518620293 PECOS PAC ID: 8022494095 Enrollment ID: I20220928000965 |
John Street Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 E John St, Lake City, MI 49651 Phone: 231-839-4359 Fax: 231-839-0223 | |
Maple Ridge Living Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2575 W Houghton Lake Rd, Lake City, MI 49651 Phone: 231-839-1011 | |
The Renaissance Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 John Street, Lake City, MI 49601 Phone: 231-839-4359 Fax: 231-839-0223 |