Med1

Primary specialty

Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X

License

4301036490 Issued in MI

Legal business name

MED1

Practice address

4433 Breton Rd SE
Kentwood, MI 49508-5273

Phone

(616) 281-6000

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Julienne Little, D.O.

Title

Medical Director

Phone

(616) 459-6331

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Tama Abel, M.D.

  • Family Medicine Physician
  • Kentwood, MI
  • NPI 1235349069
  NPD (past)
• Richard Czop, MD

  • Family Medicine Physician
  • Kentwood, MI
  • NPI 1528204229
  NPD (past)
• Duane Frank Wisk, D.O.

  • Occupational Medicine Physician
  • Holland, MI
  • NPI 1720091135
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275608234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2683 CHATHAM WOODS DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466762",
            "telephone_number": "517-927-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 BRETON RD SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085273",
            "telephone_number": "616-281-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED1",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "JULIENNE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "616-459-6331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "MI",
            "license": "4301036490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Datisia M McCoy
• Stacy Anita McGinnis, MSW
• Douglas Gene McKenzie, D.C.
• Thomas Joseph McNett-Tremblay
• Reid Meador, D.C.
• Tressa Meeuwes
• Stacey K Melville, BT
• Jazmine Mercado
• Stephanie Mewbourn
• Michelle Meyer Essenberg

• Occupational Medicine Clinic/Center in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Occupational Medicine Clinic/Center in Michigan

• 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.