Active NPI
Victor Vermeulen, MD
- Otolaryngology Physician
- West Olive, MI
National Provider Identifier
1316240906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 35029658
- Practice address
- 6171 Lakeshore Dr
West Olive, MI 49460-9139 - Phone
- (616) 786-3189
- NPI assigned
- Dec 21, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 35029658 | OH | Primary |
Addresses
Primary practice location
6171 Lakeshore Dr
West Olive, MI 49460-9139
Mailing address
6171 Lakeshore Dr
West Olive, MI 49460-9139
Phone (616) 786-3189
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35029658 | OH | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1316240906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6171 LAKESHORE DR",
"city": "WEST OLIVE",
"state": "MI",
"postal_code": "494609139",
"telephone_number": "616-786-3189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6171 LAKESHORE DR",
"city": "WEST OLIVE",
"state": "MI",
"postal_code": "494609139",
"telephone_number": "616-786-3189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERMEULEN",
"first_name": "VICTOR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-21",
"last_updated": "2010-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "OH",
"license": "35029658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Olive, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.