Brookville Pediatric & Internal Medicine, PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BROOKVILLE PEDIATRIC & INTERNAL MEDICINE, PC

Practice address

1200 56TH St SW
Wyoming, MI 49509

Phone

(616) 243-5707

Fax

(616) 243-1170

NPI assigned

Mar 27, 2006

Last updated

Apr 7, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. April A. Keizer

Title

Administrative Manag

Phone

(616) 514-3805

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 12

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.

• Brian Haskin, MD

  • Internal Medicine Physician
  • Rockford, MI
  • NPI 1437106648
  Medicare reassignment Care Compare group NPD
• Jane A Post, MD

  • Internal Medicine Physician
  • Rockford, MI
  • NPI 1982617817
  Medicare reassignment Care Compare group NPD
• Kelly Richardson, MD05/

  • Adolescent Medicine (Internal Medicine) Physician
  • Wyoming, MI
  • NPI 1548278971
  Medicare reassignment Care Compare group NPD
• David Edward Tiesma, M.D.

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1922412600
  Medicare reassignment NPD
• Jamie D. Bosch, M.D.

  • Pediatrics Physician
  • Wyoming, MI
  • NPI 1255300968
  NPD (past)
• Megan Marie Edison, M.D.

  • Pediatrics Physician
  • Wyoming, MI
  • NPI 1780657478
  NPD (past)
• Janet F Johns, M.D.

  • Pediatrics Physician
  • Wyoming, MI
  • NPI 1134197452
  NPD (past)
• Rebecca L. Maki, M.D.

  • Pediatrics Physician
  • Wyoming, MI
  • NPI 1255300950
  NPD (past)
• Benjamin G Sarver, MD

  • Pediatrics Physician
  • Grand Rapids, MI
  • NPI 1659341790
  NPD (past)
• Laurel Ann Taylor, M.D.

  • Pediatrics Physician
  • Kentwood, MI
  • NPI 1598755613
  NPD (past)
• Jenifer K.. Youngs, D.O.

  • Pediatrics Physician
  • Wyoming, MI
  • NPI 1538138128
  NPD (past)
• Lacey Janelle Althausen, MD

  • Pediatrics Physician
  • Westerville, OH
  • NPI 1548609233
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1346200847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8485 ALGOMA AVE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "49341",
            "telephone_number": "616-243-5707",
            "fax_number": "616-243-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 56TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49509",
            "telephone_number": "616-243-5707",
            "fax_number": "616-243-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKVILLE PEDIATRIC & INTERNAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "KEIZER",
        "authorized_official_first_name": "APRIL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATIVE MANAG",
        "authorized_official_telephone_number": "616-514-3805",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tucker Bronson, PAC
• Wendy Brookhouse, RD
• Bryan Douglas Brooks, NP
• Matthew Brooks, DO
• Brice Houston Brookshire, DO
• Ryan Brophy, PHARMD
• Julia Anne Brott
• Andrea Rose Brouwer, LMSW
• Kelsey Anne Brouwer, MSOT
• Matthew Brower

• Pediatrics Physician in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.