Organization Active NPI

Van Doorne Inc

  • Assistive Technology Practitioner Audiologist
  • Holland, MI
National Provider Identifier
1295950145
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistive Technology Practitioner AudiologistTaxonomy code 231HA2400X
Legal business name
VAN DOORNE INC
Practice address
391 Garden Ave
Holland, MI 49424-9602
Phone
(616) 218-0347
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Craig Vandoorne, HISNPI 1275994840
Title
Owner
Phone
(616) 796-9387

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
Assistive Technology Practitioner AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231HA2400X MI Primary

Addresses

Primary practice location

391 Garden Ave
Holland, MI 49424-9602

Mailing address

391 Garden Ave
Holland, MI 49424-9602
Phone (616) 218-0347

Other identifiers 1

IdentifierTypeStateIssuer
4729720MedicaidMI

Other names 1

  • KA VanDoorne and Assoc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001781 MI Part B Supplier - Clinic/Group Practice 5890686315 Receives reassigned benefits from 1 practitioner
Practice locations: Holland, MI

National Provider Directory

National Provider Directory

Locations

391 Garden Ave
Holland, MI 49424
Phone (616) 218-0347

Practitioners & affiliated clinicians

Practitioners 2

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1295950145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 GARDEN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249602",
            "telephone_number": "616-218-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 GARDEN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249602",
            "telephone_number": "616-218-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN DOORNE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "VANDOORNE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-796-9387",
        "authorized_official_credential": "HIS"
    },
    "taxonomies": [
        {
            "code": "231HA2400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4729720",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KA VanDoorne and Assoc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 1, 2024; 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.