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LAKE SHORE PULMONOLOGY, PLC
NPI 1245283696
Internal Medicine - Pulmonary Disease in Spring Lake, MI

Active since May 18, 2006CLIA 23D2223032 · Waiver
17357 VAN WAGONER RD, SUITE 2, SPRING LAKE, MI 49456(616) 847-1009(616) 847-1607 Get Directions Write a Review

NPPES record last updated: April 8, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Shore Pulmonology, Plc NPPES

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

LAKE SHORE PULMONOLOGY, PLC (NPI 1245283696) is a healthcare organization registered as a pulmonary disease in Spring Lake, Michigan and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists Mark James Ivey, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1245283696
Entity TypeOrganization
Primary Taxonomy207RP1001X
Legal Business NameLAKE SHORE PULMONOLOGY, PLC
Location Address17357 VAN WAGONER RD, SUITE 2Spring Lake, MI 49456-9702
Mailing Address17357 Van Wagoner Rd, Suite 2Spring Lake, MI 49456-9702 · (616) 847-1009 · Fax (616) 847-1607
Phone(616) 847-1009
Fax(616) 847-1607
Organization SubpartNo
Authorized OfficialMark James IveyOwner/physician · (616) 847-1009
Enumeration DateMay 18, 2006
Last NPPES UpdateApril 8, 2010
✔ NPI 1245283696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in MI · 4301407127
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 4301407127 (MI)
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 4301407127 (MI)
17357 VAN WAGONER RD, Spring Lake, MI 49456
Open in Google Maps ↗

Other Identifiers 1

Medicare ID-Type Unspecified0P19650MI

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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 23D2223032

Lake Shore Pulmonology, Plc · Spring Lake, MI
Active · expires May 3, 2027
CLIA Number23D2223032
Laboratory TypePhysician Office
Certificate Effective DateMay 4, 2025
Certificate Expiration DateMay 3, 2027
Laboratory DirectorCindy Mcnerlin
Laboratory Phone(616) 847-1009
Laboratory LocationLake Shore Pulmonology, Plc17357 Van Wagoner Road Suite 2, Spring Lake, MI 49456
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

CYNTHIA LEE MCNERLIN ANP-BC
Nurse Practitioner (Adult Health)
17357 VAN WAGONER RD, SUITE 2
SPRING LAKE, MI 49456
Ottawa County (616) 847-1009
DR. MARK JAMES IVEY M.D.
Internal Medicine (Pulmonary Disease)
17357 VAN WAGONER RD, SUITE 2
SPRING LAKE, MI 49456
Ottawa County (616) 847-1009

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 Lake Shore Pulmonology, Plc's NPI number?

The NPI number for Lake Shore Pulmonology, Plc is 1245283696. It was assigned to this organization in the NPPES registry on May 18, 2006.

Where is Lake Shore Pulmonology, Plc located?

Lake Shore Pulmonology, Plc is located at 17357 Van Wagoner Rd Suite 2, Spring Lake, MI 49456. The listed phone number is (616) 847-1009.

What is Lake Shore Pulmonology, Plc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Does Lake Shore Pulmonology, Plc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2223032) is associated with this NPI, valid through May 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Shore Pulmonology, Plc accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lake Shore Pulmonology, Plc 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 Lake Shore Pulmonology, Plc was last updated on April 8, 2010. 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.