NPIMap

Organization Active NPI

Michigan Urological Clinic

  • Urology Physician
  • Grand Rapids, MI
National Provider Identifier
1376586164
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
696 Issued in MI
Legal business name
MICHIGAN UROLOGICAL CLINIC
Practice address
4047 Saladin Dr SE
Grand Rapids, MI 49546-6249
Phone
(616) 956-9577
Fax
(616) 956-3090
NPI assigned
Jun 13, 2006
Last updated
Jun 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Mrs. Jill Maatman
Title
Office Manager
Phone
(616) 956-9577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 696 MI Primary

Addresses

Primary practice location

4047 Saladin Dr SE
Grand Rapids, MI 49546-6249

Mailing address

4047 Saladin Dr SE
Grand Rapids, MI 49546-6249
Phone (616) 956-9577

Other identifiers 1

IdentifierTypeStateIssuer
1376586164OtherMINPI

National Provider Directory

National Provider Directory

Locations

4047 E Hills Ct SE
Grand Rapids, MI 49546
Phone (616) 956-9577

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc29598_michiganurologicalclinic

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1376586164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 SALADIN DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466249",
            "telephone_number": "616-956-9577",
            "fax_number": "616-956-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 SALADIN DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466249",
            "telephone_number": "616-956-9577",
            "fax_number": "616-956-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN UROLOGICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "MAATMAN",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "616-956-9577",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376586164",
            "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 Jun 9, 2008; 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.