Individual provider Active NPI

Julie Ann Hutson, M.D.

  • Allergy & Immunology Physician
  • Holland, MI
National Provider Identifier
1003039199
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
4301051148 Issued in MI
Practice address
3290 N Wellness Dr Ste 180
Holland, MI 49424-8047
Phone
(616) 738-4262
Fax
(616) 738-4266
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 4301051148 MI Primary

Addresses

Primary practice location

3290 N Wellness Dr Ste 180
Holland, MI 49424-8047

Mailing address

3290 N. Wellness Dr. BLDG D Ste#180
Holland, MI 49424
Phone (616) 738-4262

Other identifiers 1

IdentifierTypeStateIssuer
4604806MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000785 MI Practitioner - Allergy/Immunology 8123035292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Allergy PCGroup PAC ID 9133136203, 2 clinicians

Practice addresses (Care Compare)

3290 N Wellness Dr
Suite 180
Holland, MI 49424-8047
Phone (616) 738-4262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Allergy PC CurrentSince Nov 1, 2005 Accepting new patients

Locations

3290 N Wellness Dr
Ste 180
Holland, MI 49424
Phone (616) 738-4262

Interoperability endpoints

  • Direct secure messaging: juliehutson@la.allscriptsdirect.net
  • FHIR API: https://fhir-myrecord.cerner.com/r4/b7350dfb-b26c-45d0-a644-be758c7d66ad/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1003039199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 N. WELLNESS DR. BLDG D STE#180",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-738-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N WELLNESS DR STE 180",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248047",
            "telephone_number": "616-738-4262",
            "fax_number": "616-738-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTSON",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "4301051148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4604806",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.