Individual provider Active NPI

Laura J Zuidema, MD

  • Maternal & Fetal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1336101260
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
4301041824 Issued in MI
Practice address
25 Michigan St NE
Suite 5200
Grand Rapids, MI 49503-2515
Phone
(616) 391-3681
Fax
(616) 391-8670
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 4301041824 MI Primary

Addresses

Primary practice location

25 Michigan St NE
Suite 5200
Grand Rapids, MI 49503-2515

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other identifiers 4

IdentifierTypeStateIssuer
1982467MedicaidMI
1558407189OtherMIGROUP NPI
1922090554OtherMIGROUP NPI
160D162280OtherMIBCBS GROUP

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1336101260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790",
            "fax_number": "616-486-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE",
            "address_2": "SUITE 5200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032515",
            "telephone_number": "616-391-3681",
            "fax_number": "616-391-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUIDEMA",
        "first_name": "LAURA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MI",
            "license": "4301041824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982467",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1558407189",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1922090554",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "160D162280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.