Individual provider Active NPI

Jason Harold Calhoun, MD

  • Orthopaedic Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1043269301
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
35093031 Issued in OH
Practice address
4100 Lake Dr SE
Suite 305
Grand Rapids, MI 49546-8292
Phone
(616) 267-8860
Fax
(616) 267-8442
NPI assigned
May 6, 2006
Last updated
Oct 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 35093031 OH Primary

Addresses

Primary practice location

4100 Lake Dr SE
Suite 305
Grand Rapids, MI 49546-8292

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other identifiers 1

IdentifierTypeStateIssuer
208414409MedicaidMO

Other names 1

  • Harold Irving Calhoun Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35093031OHMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1043269301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE",
            "address_2": "SUITE 305",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-267-8860",
            "fax_number": "616-267-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "JASON",
        "middle_name": "HAROLD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35093031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208414409",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAROLD",
            "last_name": "CALHOUN",
            "middle_name": "IRVING",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.