NPIMap

Organization Active NPI

Holland Foot and Ankle Center PC

  • Durable Medical Equipment & Medical Supplies
  • Holland, MI
National Provider Identifier
1346916624
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HOLLAND FOOT AND ANKLE CENTER PC
Practice address
904 Washington Ave
Holland, MI 49423-7724
Phone
(616) 392-7472
Fax
(616) 392-3327
NPI assigned
Aug 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Authorized official

Name
Deb Venema
Title
Business Assistant
Phone
(616) 392-7472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

904 Washington Ave
Holland, MI 49423-7724

Mailing address

904 Washington Ave
Holland, MI 49423-7724
Phone (616) 392-7472

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930013801 MI DME Supplier - Physician - Podiatry 1658265202 1 other NPI on this enrollment
Practice locations: Holland, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Holland Foot Ankle Ctr PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

901 S Bailey Ave
South Haven, MI 49090
Phone (269) 637-5405

Practitioners & affiliated clinicians

Practitioners 6

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": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1346916624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237724",
            "telephone_number": "616-392-7472",
            "fax_number": "616-392-3327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WASHINGTON AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237724",
            "telephone_number": "616-392-7472",
            "fax_number": "616-392-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLAND FOOT AND ANKLE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "VENEMA",
        "authorized_official_first_name": "DEB",
        "authorized_official_title_or_position": "BUSINESS ASSISTANT",
        "authorized_official_telephone_number": "616-392-7472"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 18, 2021; 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.