Organization Active NPI

Macatawa Surgical Associates PC

  • Surgery Physician
  • Holland, MI
National Provider Identifier
1255490397
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MACATAWA SURGICAL ASSOCIATES PC
Practice address
3290 N Wellness Dr Ste 150
Holland, MI 49424-8047
Phone
(616) 994-6677
Fax
(616) 994-6683
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jon L Schram, MDNPI 1053335018
Title
Medical Director
Phone
(616) 994-6677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3290 N Wellness Dr Ste 150
Holland, MI 49424-8047

Mailing address

PO Box 77000
Dept 77138
Detroit, MI 48277-0138
Phone (616) 994-6677

National Provider Directory

National Provider Directory

Locations

3290 N Wellness Dr
Ste 150
Holland, MI 49424
Phone (616) 294-4066

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255490397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77000",
            "address_2": "DEPT 77138",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482770138",
            "telephone_number": "616-994-6677",
            "fax_number": "616-994-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N WELLNESS DR STE 150",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248047",
            "telephone_number": "616-994-6677",
            "fax_number": "616-994-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACATAWA SURGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHRAM",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "616-994-6677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.