Active NPI
Jacob James Degraaf
- Hearing Aid Equipment
- Muskegon, MI
National Provider Identifier
1417121534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Aid Equipment
- License
- 3501004916
- Practice address
- 3308 Glade St
Muskegon, MI 49444-2708 - Phone
- (231) 733-2839
- Fax
- (231) 737-1530
- NPI assigned
- Apr 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Aid Equipment | 332S00000X | 3501004916 | MI | Primary |
Addresses
Primary practice location
3308 Glade St
Muskegon, MI 49444-2708
Mailing address
3308 Glade St
Muskegon, MI 49444-2708
Phone (231) 733-2839
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4273249 | Medicaid | MI |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3501004916 | MI | MD | Hearing Aid Equipment |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Williams Hearing | Hearing Aid Equipment | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1417121534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3308 GLADE ST",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494442708",
"telephone_number": "231-733-2839",
"fax_number": "231-737-1530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3308 GLADE ST",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494442708",
"telephone_number": "231-733-2839",
"fax_number": "231-737-1530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRAAF",
"first_name": "JACOB",
"middle_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-18",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "332S00000X",
"taxonomy_group": "",
"desc": "Hearing Aid Equipment",
"state": "MI",
"license": "3501004916",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4273249",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.