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GREAT LAKES PEDIATRIC ASSOCIATES
NPI 1023342474
Pediatrics in Lansing, MI

Active since October 01, 2009CLIA 23D1040817 · Waiver
3400 PINETREE RD, STE 102, LANSING, MI 48911(517) 887-3000 Get Directions Write a Review

NPPES record last updated: October 1, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Great Lakes Pediatric Associates NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES PEDIATRIC ASSOCIATES (NPI 1023342474) is a healthcare organization registered as a pediatrics in Lansing, Michigan and active in the NPI registry since October 2009. The organization holds a CLIA Waiver certificate valid through May 17, 2027 and lists Beth Ileen Charles, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1023342474
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameGREAT LAKES PEDIATRIC ASSOCIATES
Location Address3400 PINETREE RD, STE 102Lansing, MI 48911-4286
Mailing Address3400 Pinetree Rd, Ste 102Lansing, MI 48911-4286 · (517) 887-3000
Phone(517) 887-3000
Organization SubpartNo
Authorized OfficialBeth Ileen CharlesPractice Manager · (517) 887-3000
Enumeration DateOctober 1, 2009
✔ NPI 1023342474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in MI · 4301049233✔ Licensed in MI · 4301063626✔ Licensed in MI · 4301078945✔ Licensed in MI · 4301086445
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3400 PINETREE RD, Lansing, MI 48911
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Other Identifiers 7

Medicaid3080275MI
Other1831309921MI · Npi
Other1144338443MI · Npi
Other1144338450MI · Npi
Other1730297045MI · Npi
Medicaid3069367MI
Medicaid4366885MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1040817

Great Lakes Pediatric Associates · Lansing, MI
Active · expires May 17, 2027
CLIA Number23D1040817
Laboratory TypePhysician Office
Certificate Effective DateMay 18, 2025
Certificate Expiration DateMay 17, 2027
Laboratory DirectorAlexandra Harkins
Laboratory Phone(517) 887-3000
Laboratory LocationGreat Lakes Pediatric Associates3400 Pine Tree Road Suite 102, Lansing, MI 48911
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LESLIE K REYNOLDS MD
Pediatrics
3400 PINETREE RD, STE 102
LANSING, MI 48911
Ingham County (517) 887-3000
NATHAN J. DUNHAM, D.C., P.L.L.C.
Chiropractor
3400 PINETREE RD, SUITE 101
LANSING, MI 48911
Ingham County (517) 574-4291
CHIROPRACTIC PROFESSIONAL CENTER, PLLC
Chiropractor
3400 PINETREE RD, SUITE 101
LANSING, MI 48911
Ingham County (517) 485-0001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Pediatric Associates's NPI number?

The NPI number for Great Lakes Pediatric Associates is 1023342474. It was assigned to this organization in the NPPES registry on October 1, 2009.

Where is Great Lakes Pediatric Associates located?

Great Lakes Pediatric Associates is located at 3400 Pinetree Rd Ste 102, Lansing, MI 48911. The listed phone number is (517) 887-3000.

What is Great Lakes Pediatric Associates's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Great Lakes Pediatric Associates hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1040817) is associated with this NPI, valid through May 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Great Lakes Pediatric Associates accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Great Lakes Pediatric Associates as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Great Lakes Pediatric Associates was last updated on October 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.