NPIMap

Organization Active NPI

Michigan Pediatric Hospitalist, PC

  • Hospitalist Physician
  • Holland, MI
National Provider Identifier
1184814824
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
MICHIGAN PEDIATRIC HOSPITALIST, PC
Practice address
602 Michigan Ave
Boven Birth Center
Holland, MI 49423
Phone
(616) 393-0166
Fax
(616) 393-8821
NPI assigned
Jul 30, 2007
Last updated
Jul 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Lisa Vandenbosch
Title
Administrator
Phone
(616) 393-0166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X Primary

Addresses

Primary practice location

602 Michigan Ave
Boven Birth Center
Holland, MI 49423

Mailing address

926 Washington Ave
Building C
Holland, MI 49423-7725
Phone (616) 393-0166

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1184814824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 WASHINGTON AVE",
            "address_2": "BUILDING C",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237725",
            "telephone_number": "616-393-0166",
            "fax_number": "616-393-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "address_2": "BOVEN BIRTH CENTER",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-393-0166",
            "fax_number": "616-393-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PEDIATRIC HOSPITALIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "VANDENBOSCH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "616-393-0166"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.