Individual provider Active NPI

Jodie Loomans

  • Case Manager/Care Coordinator
  • Allegan, MI
National Provider Identifier
1053783092
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
6401014757 Issued in MI
Practice address
3283 122ND Ave
PO Drawer 130
Allegan, MI 49010-9511
Phone
(269) 686-5124
NPI assigned
Oct 29, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 6401014757 MI Primary

Addresses

Primary practice location

3283 122ND Ave
PO Drawer 130
Allegan, MI 49010-9511

Mailing address

3283 122ND Ave
PO Drawer 130
Allegan, MI 49010-9511
Phone (616) 403-7102

Other identifiers 1

IdentifierTypeStateIssuer
171M00000XMedicaidMI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401014757MIMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Allegan County Community Mental Health Past Accepting new patients

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": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1053783092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3283 122ND AVE",
            "address_2": "PO DRAWER 130",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109511",
            "telephone_number": "616-403-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3283 122ND AVE",
            "address_2": "PO DRAWER 130",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109511",
            "telephone_number": "269-686-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMANS",
        "first_name": "JODIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "6401014757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171M00000X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.