Holy Family Healthcare

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5101011443 Issued in MI

Legal business name

HOLY FAMILY HEALTHCARE

Practice address

301 N Center St
Hartford, MI 49057-1199

Phone

(269) 621-0011

NPI assigned

Jan 21, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Don D Bouchard, D.O.

Title

President

Phone

(269) 279-9332

Specialties & licenses 8

Addresses

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1154744597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N CENTER ST",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490571199",
            "telephone_number": "269-621-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N CENTER ST",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490571199",
            "telephone_number": "269-621-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4408 S Westnedge Ave",
            "address_2": "c/o St. Monica Parish",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490083210",
            "country_code": "US",
            "telephone_number": "269-270-9332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOLY FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-21",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "BOUCHARD",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-279-9332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094934",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101011443",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MI",
            "license": "6801094934",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002054",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dalena Haddock, B.S
• Shelby Hall
• Andrew Bruce Hamilton, D.D.S.
• Elizabeth Sally Hodge, LPN
• Holy Family Dental Clinics
• Holy Family Healthcare
• Douglas Scott Johansen, DDS
• Lisa Johnson, RDH
• Peter John Koshar Jr., LMSW
• Steven Jay Koster, COUNSELRO EDUC LTD

• Pediatrics Physician in Hartford, MI
• Providers in Hartford, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.