Active NPI
Holland Community Hospital
- Foot & Ankle Surgery Podiatrist
- Holland, MI
National Provider Identifier
1093219743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- Legal business name
- HOLLAND COMMUNITY HOSPITAL
- Practice address
- 3299 N Wellness Dr Ste 230
Holland, MI 49424-7271 - Phone
- (616) 399-1369
- Fax
- (616) 738-7858
- NPI assigned
- Mar 19, 2018
- Last updated
- Mar 10, 2023
- Organization subpart
- Yes
- Parent organization
- HOLLAND COMMUNITY HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alexander Roehling
- Title
- Cfo
- Phone
- (616) 394-3456
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | Primary |
Addresses
Primary practice location
3299 N Wellness Dr Ste 230
Holland, MI 49424-7271
Mailing address
3299 N Wellness Dr Ste 230
Holland, MI 49424-7271
Phone (616) 399-1369
Other names 1
- Holland Hospital Foot & Ankle
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031218000484 | MI | Part B Supplier - Clinic/Group Practice | 0446157291 |
Receives reassigned benefits from 167 practitioners 28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Holland, MI; Zeeland, MI; Saugatuck, MI; Hudsonville, MI; Grand Haven, MI |
Other NPIs on the same Medicare enrollment 28
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Holland Hospital Primary Care - Grand Haven
- Family Medicine Physician
- Grand Haven, MI
- NPI 1225784580
O20031218000484
-
dba d/b/a Holland Hospital
- Hospitalist Physician
- Holland, MI
- NPI 1497090617
O20031218000484
National Provider Directory
National Provider Directory- Part of
- Hamilton Medical Associ
Locations
175 S Waverly Rd
Ste B
Holland, MI 49423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521417600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678406400000",
"number": "1093219743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3299 N WELLNESS DR STE 230",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494247271",
"telephone_number": "616-399-1369",
"fax_number": "616-738-7858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3299 N WELLNESS DR STE 230",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494247271",
"telephone_number": "616-399-1369",
"fax_number": "616-738-7858"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLLAND COMMUNITY HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HOLLAND COMMUNITY HOSPITAL",
"enumeration_date": "2018-03-19",
"last_updated": "2023-03-10",
"certification_date": "2023-03-10",
"status": "A",
"authorized_official_last_name": "ROEHLING",
"authorized_official_first_name": "ALEXANDER",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "616-394-3456"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Holland Hospital Foot & Ankle",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.