John David Nicely, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

4301078807 Issued in MI

Practice address

602 Michigan Ave
Holland, MI 49423

Phone

(616) 394-3522

NPI assigned

May 11, 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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Epi PC

  • Emergency Medicine Physician
  • Holland, MI
  • NPI 1225082266
  Medicare reassignment NPD
• Holland Community Hospital

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holland, MI
  • NPI 1780888099
  Medicare reassignment NPD
• Holland Community Hospital

  • General Acute Care Hospital
  • Holland, MI
  • NPI 1871672618
  NPD
• Holland Community Hospital

  • Family Medicine Physician
  • Hudsonville, MI
  • NPI 1952130585
  NPD
• Holland Community Hospital

  • Psychiatry Physician
  • Holland, MI
  • NPI 1790985588
  NPD (past)
• Holland Community Hospital

  • Otolaryngology Physician
  • Holland, MI
  • NPI 1982910857
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274745600000",
    "number": "1215987367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 4006",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "616-975-1845",
            "fax_number": "616-975-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-394-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICELY",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301078807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00161815",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jake Newhouse, BEHAVIOR TECH
• Sharon Elizabeth Newhouse, MA, LLPC
• Hoan H Nguyen
• Nhuquynh Nguyen, RPH
• Bryan Ni, MD
• Linda Nichols, PTA
• Jeffrey Allen Nieboer, RPH
• Ria Anastasia Nieboer, LMSW, CAADC, ADS
• Heidi Nienhuis
• Amanda Nies, D.O.

• Emergency Medical Services (Emergency Medicine) Physician in Holland, MI
• Providers in Holland, MI by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.