Individual provider Active NPI

Melinda Huizenga, RN

  • Home Health Registered Nurse
  • Grand Rapids, MI
National Provider Identifier
1194248815
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
4704295830 Issued in MI
Practice address
5300 Patterson Ave SE Ste 125
Grand Rapids, MI 49512
Phone
(616) 222-5601
Fax
(866) 941-7479
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 4704295830 MI Primary

Addresses

Primary practice location

5300 Patterson Ave SE Ste 125
Grand Rapids, MI 49512

Mailing address

5300 Patterson Ave SE Ste 125
Grand Rapids, MI 49512-9627
Phone (616) 222-5601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704295830MIMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194248815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 PATTERSON AVE SE STE 125",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495129627",
            "telephone_number": "616-222-5601",
            "fax_number": "866-941-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 PATTERSON AVE SE STE 125",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49512",
            "telephone_number": "616-222-5601",
            "fax_number": "866-941-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUIZENGA",
        "first_name": "MELINDA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MI",
            "license": "4704295830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.