NPIMap

Organization Active NPI

Holland Community Hospital

Doing business as Holland Hospital Primary Care - Grand Haven

  • Family Medicine Physician
  • Grand Haven, MI
National Provider Identifier
1225784580
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HOLLAND COMMUNITY HOSPITAL
Doing business as
Holland Hospital Primary Care - Grand Haven
Practice address
1600 S Beacon Blvd Ste 240
Grand Haven, MI 49417-2654
Phone
(616) 394-2079
NPI assigned
Feb 25, 2022
Last updated
Jun 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Authorized official

Name
Alexander Roehling
Title
Cfo
Phone
(616) 394-3456

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU Primary
Sports Medicine (Family Medicine) Physician 207QS0010X NU

Addresses

Primary practice location

1600 S Beacon Blvd Ste 240
Grand Haven, MI 49417-2654

Mailing address

1600 S Beacon Blvd Ste 240
Grand Haven, MI 49417-2654
Phone (616) 394-2079

Other names 1

  • Holland Hospital Primary Care - Grand Haven Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000484 MI Part B Supplier - Clinic/Group Practice 0446157291 Receives reassigned benefits from 167 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Holland, MI; Zeeland, MI; Saugatuck, MI; Hudsonville, MI; Grand Haven, MI

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2255022Holland Hospital Primary Care - Grand Haven1600 S Beacon Blvd Suite 240, Grand Haven, MI 49417Provider-performed microscopyMar 8, 2028

National Provider Directory

National Provider Directory

Locations

1600 S Beacon Blvd
Grand Haven, MI 49417
Phone (614) 954-0600

Practitioners & affiliated clinicians

Practitioners 5

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": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1225784580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S BEACON BLVD STE 240",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172654",
            "telephone_number": "616-394-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S BEACON BLVD STE 240",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172654",
            "telephone_number": "616-394-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLAND COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "ROEHLING",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-394-3456"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holland Hospital Primary Care - Grand Haven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.