Douglas Moorhead, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301012346 Issued in MI

Practice address

17224 Van Wagoner Rd
Spring Lake, MI 49456-9702

Phone

(616) 296-2130

NPI assigned

Feb 3, 2017

Last updated

Feb 3, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kristine Koetje Ma, PC

  dba Compassionate Christian Counseling

  • Psychologist
  • Spring Lake, MI
  • NPI 1316010770
  Medicare reassignment

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1396283826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 HATHAWAY CT",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494414435",
            "telephone_number": "231-329-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17224 VAN WAGONER RD",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-296-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORHEAD",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Medical PC
• Michigan Medical, PC.
• Dean T Millar, PT
• Ashley Moblo
• Heather L Molnar, AT,ATC
• Jamie Morris, PT, OCS, COMT, ISST
• Phillip Allen Morse, R.PH.
• Tierney D Mosier, LLMSW
• Samantha Murphy, D.C.
• John M Nametz, O.D.

• Psychologist in Spring Lake, MI
• Providers in Spring Lake, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.