Alan L Nieboer, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704120574 Issued in MI

Practice address

204 W Main St
Fremont, MI 49412-1181

Phone

(231) 924-1800

Fax

(231) 924-1810

NPI assigned

Aug 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Newaygo County General Hospital Association

  dba Corewell Health Gerber Hospital

  • Critical Access Hospital
  • Fremont, MI
  • NPI 1063836963
  NPD (past)
• Newaygo County General Hospital Association

  • Emergency Medicine Physician
  • Fremont, MI
  • NPI 1629070982
  NPD (past)
• Newaygo County General Hospital Association

  dba Corewell Health Gerber Hospital Professional

  • Hospitalist Physician
  • Fremont, MI
  • NPI 1750404927
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1174631485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S SULLIVAN AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121548",
            "telephone_number": "231-924-3300",
            "fax_number": "231-924-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W MAIN ST",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121181",
            "telephone_number": "231-924-1800",
            "fax_number": "231-924-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBOER",
        "first_name": "ALAN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704120574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4383367",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Newaygo County General Hospital Association (Corewell Health Gerber Hospital Pediatrics & Walk-In Clinic - Fremont)
• Newaygo County General Hospital Association (Corewell Health Gerber Hospital Professional)
• Newaygo County Resa
• Newaygo Medical Care Facility
• Mai Phuong Nguyen Dang, DO
• Christopher Callis Niquette, DDS
• Julie A Norris, M.D.
• David Wayne Oosting, O.D.
• Ashly Aleese Ott, PA-C
• Bunnita Marie Ouwinga, LLP

• Gerontology Nurse Practitioner in Fremont, MI
• Providers in Fremont, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; 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.