Individual provider Active NPI

Allison Boonie, NP-C

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1174948384
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
47042288626 Issued in MI
Practice address
1959 E Paris Ave SE
Grand Rapids, MI 49546-6272
Phone
(616) 363-7690
Fax
(616) 363-7680
NPI assigned
Feb 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 47042288626 MI Primary

Addresses

Primary practice location

1959 E Paris Ave SE
Grand Rapids, MI 49546-6272

Mailing address

1959 E Paris Ave SE
Grand Rapids, MI 49546-6272
Phone (616) 363-7690

Other names 1

  • Miss Allison Friske Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140703001692 MI Practitioner - Nurse Practitioner 2062637176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine and Pediatrics of West Michigan LLCGroup PAC ID 6305090507, 8 clinicians

Practice addresses (Care Compare)

655 Kenmoor Ave SE
Suite 200
Grand Rapids, MI 49546-8622
Phone (616) 363-7690

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47042288626MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine and Pediatrics of West Michigan CurrentSince May 6, 2014 Accepting new patients
Dawm, PLC PastSince Apr 3, 2000 Accepting new patients

Locations

1959 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 285-3700

655 Kenmoor Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 363-7690

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1174948384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466272",
            "telephone_number": "616-363-7690",
            "fax_number": "616-363-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466272",
            "telephone_number": "616-363-7690",
            "fax_number": "616-363-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONIE",
        "first_name": "ALLISON",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "47042288626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "FRISKE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.