Active NPI
William J Venema, MD
- Pediatrics Physician
- Kalamazoo, MI
National Provider Identifier
1225008782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301025837
- Practice address
- 5629 Stadium Dr
Bronson Rambling Road Pediatrics
Kalamazoo, MI 49009-1952 - Phone
- (269) 371-1000
- Fax
- (269) 372-0698
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301025837 | MI | Primary |
Addresses
Primary practice location
5629 Stadium Dr
Bronson Rambling Road Pediatrics
Kalamazoo, MI 49009-1952
Mailing address
601 John St
Box 42
Kalamazoo, MI 49007-5341
Phone (269) 341-7806
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4467331 | Medicaid | MI |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301025837 | MI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194393600000",
"number": "1225008782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 JOHN ST",
"address_2": "BOX 42",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490075341",
"telephone_number": "269-341-7806",
"fax_number": "269-341-8743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5629 STADIUM DR",
"address_2": "BRONSON RAMBLING ROAD PEDIATRICS",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490091952",
"telephone_number": "269-371-1000",
"fax_number": "269-372-0698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENEMA",
"first_name": "WILLIAM",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2007-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301025837",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4467331",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.