Active NPI
Jenison Podiatry PC
- Podiatrist
- Jenison, MI
National Provider Identifier
1477530954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- JENISON PODIATRY PC
- Practice address
- 669 Baldwin St
Jenison, MI 49428-7903 - Phone
- (616) 457-7171
- Fax
- (616) 457-1121
- NPI assigned
- Dec 27, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Gene L Oosterhouse, DPM
- Title
- Vice President
- Phone
- (616) 457-7171
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
669 Baldwin St
Jenison, MI 49428-7903
Mailing address
4310 Leonard St NW
Suite 103
Walker, MI 49534
Phone (616) 453-6329
National Provider Directory
National Provider DirectoryLocations
669 Baldwin St
Jenison, MI 49428
Phone (616) 457-7171
4310 Leonard St NW
Ste 103
Walker, MI 49534
Phone (616) 453-0600
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Jenison, MI
- NPI 1861479669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1296518400000",
"number": "1477530954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4310 LEONARD ST NW",
"address_2": "SUITE 103",
"city": "WALKER",
"state": "MI",
"postal_code": "49534",
"telephone_number": "616-453-6329",
"fax_number": "616-453-1725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "669 BALDWIN ST",
"city": "JENISON",
"state": "MI",
"postal_code": "494287903",
"telephone_number": "616-457-7171",
"fax_number": "616-457-1121"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JENISON PODIATRY PC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-27",
"last_updated": "2011-02-01",
"status": "A",
"authorized_official_last_name": "OOSTERHOUSE",
"authorized_official_first_name": "GENE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "616-457-7171",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jenison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.