LAKE SHORE PULMONOLOGY, PLC
NPI 1245283696
Internal Medicine - Pulmonary Disease in Spring Lake, MI
NPI Status: Active since May 18, 2006
Contact Information
17357 VAN WAGONER RD
SUITE 2
SPRING LAKE, MI
ZIP 49456
Phone: (616) 847-1009
Fax: (616) 847-1607
- Organization
- Internal Medicine
- Pulmonary Disease
- Accepts Insurance
- CLIA Number: 23D2223032
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-03-2027
About LAKE SHORE PULMONOLOGY, PLC
This page provides the complete NPI Profile along with additional information for Lake Shore Pulmonology, Plc, an internist established in Spring Lake, Michigan operating as a Internal Medicine, focusing in pulmonary disease . The healthcare provider is registered in the NPI registry with number 1245283696 assigned on May 2006. The practitioner's primary taxonomy code is 207RP1001X with license number 4301407127 (MI). The provider is registered as an organization and their NPI record was last updated 16 years ago. Lake Shore Pulmonology, Plc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mark James Ivey M.d. (Owner/physician)
- NPI
- 1245283696
- Provider Name
- LAKE SHORE PULMONOLOGY, PLC
- Entity Type
- Organization
- Location Address
- 17357 VAN WAGONER RD SUITE 2 SPRING LAKE, MI 49456
- Location Phone
- (616) 847-1009
- Location Fax
- (616) 847-1607
- Mailing Address
- 17357 VAN WAGONER RD SUITE 2 SPRING LAKE, MI 49456
- Mailing Phone
- (616) 847-1009
- Mailing Fax
- (616) 847-1607
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-18-2006
- Last Update Date
- 04-08-2010
- Code Navigator
An internist like Lake Shore Pulmonology, Plc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Pulmonary Disease
- Taxonomy Code
- 207RP1001X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 4301407127
- License State
- MI
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | 4301407127 (MI) |
| 2 | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | 4301407127 (MI) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0P19650 | MEDICARE ID-TYPE UNSPECIFIED (04) | MI |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D2223032
- Facility Type
- Physician Office
- Certificate Effective Date
- May 04, 2025
- Certificate Expiration Date
- May 03, 2027
- Laboratory Director
- CINDY MCNERLIN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lake Shore Pulmonology, Plc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for LAKE SHORE PULMONOLOGY, PLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1245283696, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 74 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
SPRING LAKE, MI 49456
SPRING LAKE, MI 49456
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245283696, enumerated as an "organization" on May 18, 2006.
The provider is located at 17357 VAN WAGONER RD SUITE 2 SPRING LAKE, MI 49456 and the phone number is (616) 847-1009.
Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.
The provider might be accepting Accepts: Blue Cross Blue Shield of Michigan Mutual. Please consult your insurance carrier or call the provider to verify.
