Organization Active NPI

Northwood Foot and Ankle Center, PC

  • Podiatrist
  • Holland, MI
National Provider Identifier
1104046325
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001739 Issued in MI
Legal business name
NORTHWOOD FOOT AND ANKLE CENTER, PC
Practice address
388 Garden Ave
Suite 120
Holland, MI 49424-8998
Phone
(616) 393-8886
Fax
(616) 393-9975
NPI assigned
Apr 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Patricia Guisinger, D.P.M.
Title
President
Phone
(616) 393-8886

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5901001739 MI Primary
Durable Medical Equipment & Medical Supplies 332B00000X 5901001739 MI

Addresses

Primary practice location

388 Garden Ave
Suite 120
Holland, MI 49424-8998

Mailing address

388 Garden Ave
Suite 120
Holland, MI 49424-8999
Phone (616) 393-8886

Other identifiers 3

IdentifierTypeStateIssuer
480029237OtherMIMEDICARE RAILROAD
3516763MedicaidMI
4857010700OtherMIBLUE CROSS

National Provider Directory

National Provider Directory

Locations

388 Garden Ave
Ste 120
Holland, MI 49424
Phone (616) 201-3334

1901 Niles Ave
Ste 201
Saint Joseph, MI 49085
Phone (269) 429-7670

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1104046325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 GARDEN AVE",
            "address_2": "SUITE 120",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248999",
            "telephone_number": "616-393-8886",
            "fax_number": "616-393-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 GARDEN AVE",
            "address_2": "SUITE 120",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248998",
            "telephone_number": "616-393-8886",
            "fax_number": "616-393-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWOOD FOOT AND ANKLE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "GUISINGER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-393-8886",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001739",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5901001739",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480029237",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3516763",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4857010700",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 17, 2022; 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.