Lonna Petronella Van Ast, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601002990 Issued in MI

Practice address

1022 Ada Place Dr SE
Grand Rapids, MI 49546-3786

Phone

(616) 550-0427

NPI assigned

Jul 14, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1093028441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 ADA PLACE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1022 ADA PLACE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463786",
            "telephone_number": "616-550-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN AST",
        "first_name": "LONNA",
        "middle_name": "PETRONELLA",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601002990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Olivia Valley
• Elizabeth Jane Vallier-Booth, LLMSW
• Katelyn Van Allsburg, NP-C
• Tim Van Antwerp
• Karin Mayoga Van Ast, LLC
• Dillene Joanna Van Beek, BS
• Ruth Esther Van Beek, MSW
• Sandra Van Brouwer, APN
• Shaunene Van Buren, PSYD
• Ashley Anne Van Dam, PT, DPT

• Surgical Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Surgical Physician Assistant in Michigan

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