NPIMap

Organization Active NPI

Shoreline Orthopaedic & Sports Medicine Clinic,PLC

  • Orthopaedic Surgery Physician
  • Holland, MI
National Provider Identifier
1275579765
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SHORELINE ORTHOPAEDIC & SPORTS MEDICINE CLINIC,PLC
Practice address
370 120TH Ave
Holland, MI 49424-2196
Phone
(616) 396-5855
Fax
(616) 396-5720
NPI assigned
Jun 21, 2006
Last updated
Mar 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Authorized official

Name
Mrs. Tricia Schildhouse
Title
Practice Manager
Phone
(616) 396-5855

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Orthopaedic Surgery Physician 207X00000X Primary
Orthopaedic Hand Surgery Physician 207XS0106X MI
Non-Pharmacy Dispensing Site 332900000X

Addresses

Primary practice location

370 120TH Ave
Holland, MI 49424-2196

Mailing address

370 N 120TH Ave
Holland, MI 49424-2120
Phone (616) 396-5855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040623000868 MI Part B Supplier - Clinic/Group Practice 6002891926 Receives reassigned benefits from 35 practitioners
1 other NPI on this enrollment
Practice locations: Hudsonville, MI; Zeeland, MI; Holland, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

370 N 120th Ave
Ste 20
Holland, MI 49424
Phone (616) 396-5855

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1275579765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 N 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242120",
            "telephone_number": "616-396-5855",
            "fax_number": "616-396-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242196",
            "telephone_number": "616-396-5855",
            "fax_number": "616-396-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE ORTHOPAEDIC & SPORTS MEDICINE CLINIC,PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "SCHILDHOUSE",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "616-396-5855",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.