Individual provider Active NPI

Mark Norval Folkening, MD

  • Family Medicine Physician
  • Holland, MI
National Provider Identifier
1033229950
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MF031213 Issued in MI
Practice address
111 Lakeview Ave
Holland, MI 49424-2250
Phone
(616) 502-7144
Fax
(616) 786-0185
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MF031213 MI Primary

Addresses

Primary practice location

111 Lakeview Ave
Holland, MI 49424-2250

Mailing address

111 Lakeview Ave
Holland, MI 49424-2250
Phone (616) 502-7144

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
I20050425000310 MI Practitioner - General PracticePractitioner - Family Practice 2860430378 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MF031213MIMDFamily Medicine Physician

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1033229950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 LAKEVIEW AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242250",
            "telephone_number": "616-502-7144",
            "fax_number": "616-786-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LAKEVIEW AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242250",
            "telephone_number": "616-502-7144",
            "fax_number": "616-786-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLKENING",
        "first_name": "MARK",
        "middle_name": "NORVAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "MF031213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.