Organization Active NPI

Jenison Podiatry PC

  • Podiatrist
  • Jenison, MI
National Provider Identifier
1477530954
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
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

Updated by the provider on Feb 1, 2011

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)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.