Tracy Vanden Bosch

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704274877 Issued in MI

Practice address

551 Linn St
Suite 150
Allegan, MI 49010-1595

Phone

(269) 686-5800

Fax

(269) 686-5899

NPI assigned

Feb 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tracy Koning Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakewood Family Medicine PLCGroup PAC ID 0749290740, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holland Hospital Hospital, Holland, MI, CCN 230072

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lakewood Family Medicine PLC

  • Family Medicine Physician
  • Holland, MI
  • NPI 1073609392
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holland Community Hospital

  dba Holland Hospital

  • General Acute Care Hospital
  • Holland, MI
  • NPI 1871672618
  Care Compare affiliation

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1528450525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 N 120TH AVE",
            "address_2": "SUITE 150",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242169",
            "telephone_number": "616-796-3414",
            "fax_number": "616-396-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 LINN ST",
            "address_2": "SUITE 150",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101595",
            "telephone_number": "269-686-5800",
            "fax_number": "269-686-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEN BOSCH",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704274877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "KONING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Trinity Home Health Agency LLC
• Tru Home Help Care, LLC
• Michell R Truax, MA LLP
• Martin Joseph Trumbull, OTR
• Value Drugs of Allegan Inc (Moore Family Pharmacy Allegan)
• Rachel Anne Vandenbrink, D.O.
• Cassie L Vandervelden, NP
• Elondra Varice
• Ampapone Khamsana Vongsiprasom, COTA
• Linda S Wadsworth, NP

• Family Nurse Practitioner in Allegan, MI
• Providers in Allegan, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.