William Glenn Bouman, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

4301025391 Issued in MI

Practice address

1141 High Point Dr. NW
Grand Rapids, MI 49544-7341

Phone

(616) 785-8559

NPI assigned

Nov 2, 2012

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1154675825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 HIGH POINT DR. NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "459447341",
            "telephone_number": "616-785-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 HIGH POINT DR. NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495447341",
            "telephone_number": "616-785-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUMAN",
        "first_name": "WILLIAM",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-02",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301025391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Boulerice
• Hany Boulos, DDS
• Christopher Michael Bouma, DNP, AGPCNP-BC, RN
• Douglas A Bouman, PSYSLLP
• Kristin Bouman
• Shirley Marie Bounds, RRT
• Vanida Bounthapanya
• Kristina Ann Bourdo-Moulder, BCBA, LBA
• Morgan Bourgeois
• Alexander Bourke

• Nephrology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Nephrology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.