Carly N Molenkamp

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704314132 Issued in MI

Practice address

3165 24TH Ave
Hudsonville, MI 49426-9656

Phone

(616) 896-8382

NPI assigned

Feb 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• David Charles Tattan, D.O.

  • Family Medicine Physician
  • Jamestown, MI
  • NPI 1992751887
  Medicare reassignment

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1245824556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6527 MADISON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486984",
            "telephone_number": "616-551-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 24TH AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494269656",
            "telephone_number": "616-896-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLENKAMP",
        "first_name": "CARLY",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704314132",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704314132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Lee Mier, DO
• Cindy Miller
• Hannah Lucia Miller
• Kimberly Bain Mitcham, D.O.
• Caitlin Mlynarek, D.O.
• Janette Molenkamp
• Tina Marie Monahon, MA, CCC-SLP, CBIS
• Carolyn Diane Moore, MA, CCC-SLP
• Ellen Moore, MD
• Amy Elizabeth Mulder, PA-C

• Family Nurse Practitioner in Hudsonville, MI
• Providers in Hudsonville, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.