Individual provider Active NPI

Thomas Nelson Verhage, RPH

  • Pharmacist
  • Grand Rapids, MI
National Provider Identifier
1114137882
Registry record updated Jul 8, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(3) exclusion effective Aug 20, 2014.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302020582 Issued in MI
Practice address
6680 Kalamazoo Ave SE
Grand Rapids, MI 49508-7030
Phone
(616) 554-1964
Fax
(616) 554-3140
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302020582 MI Primary

Addresses

Primary practice location

6680 Kalamazoo Ave SE
Grand Rapids, MI 49508-7030

Mailing address

4528 Carrick Ave SE
Kentwood, MI 49508-4526
Phone (616) 532-3934

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302020582MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentwood Pharmacy Pharmacist 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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114137882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4528 CARRICK AVE SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495084526",
            "telephone_number": "616-532-3934",
            "fax_number": "616-532-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6680 KALAMAZOO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087030",
            "telephone_number": "616-554-1964",
            "fax_number": "616-554-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERHAGE",
        "first_name": "THOMAS",
        "middle_name": "NELSON",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302020582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.