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GREAT LAKES UROGYNECOLOGY PLC
NPI 1144111840
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Brownstown Twp, MI

Active since July 10, 2025CLIA 23D2330379 · Waiver
19249 ALLEN RD STE B, BROWNSTOWN TWP, MI 48183(248) 835-2797 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 5, 2025, Jul 10, 2025 (2 updates tracked since 2025).

About Great Lakes Urogynecology Plc NPPES

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

GREAT LAKES UROGYNECOLOGY PLC (NPI 1144111840) is a healthcare organization registered as an urogynecology and reconstructive pelvic surgery in Brownstown Twp, Michigan and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through September 15, 2027 and lists Jaclyn Taylor Baratono, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1144111840
Entity TypeOrganization
Primary Taxonomy207VF0040X
Legal Business NameGREAT LAKES UROGYNECOLOGY PLC
Location Address19249 ALLEN RD STE BBrownstown Twp, MI 48183-1189
Mailing Address19249 Allen Rd Ste BBrownstown Twp, MI 48183-1189 · (734) 225-6859
Phone(248) 835-2797
Organization SubpartNo
Authorized OfficialJaclyn Taylor BaratonoAuthorized Official · (734) 225-6859
Enumeration DateJuly 10, 2025
Last NPPES UpdateAugust 5, 20252 updates tracked since enumeration
NPPES CertifiedAugust 5, 2025
✔ NPI 1144111840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Urogynecology and Reconstructive Pelvic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207VF0040X
Definition
A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.
19249 ALLEN RD STE B, Brownstown Twp, MI 48183
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 23D2330379

Great Lakes Urogynecology Plc · Brownstown, MI
Active · expires Sep 15, 2027
CLIA Number23D2330379
Laboratory TypePhysician Office
Certificate Effective DateSeptember 16, 2025
Certificate Expiration DateSeptember 15, 2027
Laboratory DirectorJaclyn T. Baratono
Laboratory Phone(734) 225-6859
Laboratory LocationGreat Lakes Urogynecology Plc19249 Allen Road Suite B, Brownstown, MI 48183
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Urogynecology Plc's NPI number?

The NPI number for Great Lakes Urogynecology Plc is 1144111840. It was assigned to this organization in the NPPES registry on July 10, 2025.

Where is Great Lakes Urogynecology Plc located?

Great Lakes Urogynecology Plc is located at 19249 Allen Rd Ste B, Brownstown Twp, MI 48183. The listed phone number is (248) 835-2797.

What is Great Lakes Urogynecology Plc's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 207VF0040X.

Does Great Lakes Urogynecology Plc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2330379) is associated with this NPI, valid through September 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Great Lakes Urogynecology Plc was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.