Thomas W Pfennig, D.O., FAOCO

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

5101009647 Issued in MI

Practice address

1555 44TH St SW
Wyoming, MI 49509-4395

Phone

(616) 249-8000

Fax

(616) 249-8088

NPI assigned

Apr 19, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Thomas W Pfennig DO

  dba Grand Rapids Ear Nose and Throat PC

  • Otolaryngology Physician
  • Wyoming, MI
  • NPI 1063639870
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508821901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 44TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094395",
            "telephone_number": "616-249-8000",
            "fax_number": "616-249-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 44TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094395",
            "telephone_number": "616-249-8000",
            "fax_number": "616-249-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFENNIG",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "D.O., FAOCO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "5101009647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2854990",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Sue Perkins, LPN
• Julie Anne Perski, NP-C
• Trevor Peterson, MD
• Alexus Marie Petrick, PHARMD
• Kyle E Pfeifer, MD
• Barbara Elizabeth Phillips
• Morgan Phillips
• Bruce M Philpott
• Phoenix Rising Counseling L.L.C
• Abbey Mikala Pierce

• Otolaryngology Physician in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.