TR Degroot MD PLLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

TD038705 Issued in MI

Legal business name

TR DEGROOT MD PLLC

Practice address

1101 Columbus Ave
Grand Haven, MI 49417

Phone

(616) 847-3144

Fax

(616) 847-8416

NPI assigned

Jun 8, 2012

Organization subpart

No

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

Authorized official

Name

Terry R Degroot, M.D.

Title

Owner

Phone

(616) 502-1997

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1174885941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 COLUMBUS AVE.",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "49417",
            "telephone_number": "616-847-3144",
            "fax_number": "616-847-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 COLUMBUS AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "49417",
            "telephone_number": "616-847-3144",
            "fax_number": "616-847-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TR DEGROOT MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-08",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "DEGROOT",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-502-1997",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "TD038705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.