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LAKE MICHIGAN NEPHROLOGY, L.L.C
NPI 1821201500
Specialist in Saint Joseph, MI

Active since May 08, 2007CLIA 23D0723416 · Microscopy
3800 HOLLYWOOD RD STE 104, SAINT JOSEPH, MI 49085(269) 428-0819(269) 428-0841 Get Directions Write a Review

NPPES record last updated: October 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lake Michigan Nephrology, L.l.c NPPES

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

LAKE MICHIGAN NEPHROLOGY, L.L.C (NPI 1821201500) is a healthcare organization registered as a specialist in Saint Joseph, Michigan and active in the NPI registry since May 2007. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Daniel William Brash, Owner, as its authorized official.

NPPES Registry Identity

NPI1821201500
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameLAKE MICHIGAN NEPHROLOGY, L.L.C
Location Address3800 HOLLYWOOD RD STE 104Saint Joseph, MI 49085-8511
Mailing Address3800 Hollywood Rd, Suite 104Saint Joseph, MI 49085-8510 · (269) 428-0819 · Fax (269) 428-0841
Phone(269) 428-0819
Fax(269) 428-0841
Organization SubpartNo
Authorized OfficialDaniel William BrashOwner · (269) 428-0819
Enumeration DateMay 8, 2007
Last NPPES UpdateOctober 5, 2023
NPPES CertifiedOctober 5, 2023
✔ NPI 1821201500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MI · 4301079804
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3800 HOLLYWOOD RD STE 104, Saint Joseph, MI 49085
Open in Google Maps ↗

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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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 for Provider-Performed Microscopy Procedures (PPMP) 23D0723416

Lake Michigan Nephrology · Saint Joseph, MI
Active · expires Aug 31, 2026
CLIA Number23D0723416
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKatherine Kwon
Laboratory Phone(269) 428-0819
Laboratory LocationLake Michigan Nephrology3800 Hollywood Road Suite 104, Saint Joseph, MI 49085
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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.

DEBORA TENTER NP
Nurse Practitioner (Family)
3800 HOLLYWOOD RD STE 104
SAINT JOSEPH, MI 49085
Berrien County (269) 428-0819
CARRI DAWN MCCARTHY NP-C
Nurse Practitioner (Gerontology)
3800 HOLLYWOOD RD STE 104
SAINT JOSEPH, MI 49085
Berrien County (269) 428-0819
MR. TERRY NEIL MEHIGAN FNP
Nurse Practitioner (Primary Care)
3800 HOLLYWOOD RD STE 104
SAINT JOSEPH, MI 49085
Berrien County (269) 428-0819

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 Michigan Nephrology, L.L.C's NPI number?

The NPI number for Lake Michigan Nephrology, L.L.C is 1821201500. It was assigned to this organization in the NPPES registry on May 8, 2007.

Where is Lake Michigan Nephrology, L.L.C located?

Lake Michigan Nephrology, L.L.C is located at 3800 Hollywood Rd Ste 104, Saint Joseph, MI 49085. The listed phone number is (269) 428-0819.

What is Lake Michigan Nephrology, L.L.C's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Lake Michigan Nephrology, L.L.C hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0723416) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Michigan Nephrology, L.L.C accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lake Michigan Nephrology, L.L.C 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 Michigan Nephrology, L.L.C was last updated on October 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.