Individual provider Active NPI

Jennifer Boven, NP

  • Family Nurse Practitioner
  • Holland, MI
National Provider Identifier
1528534716
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704297099 Issued in MI
Practice address
577 Michigan Ave Ste 201
Holland, MI 49423-4911
Phone
(616) 392-1816
NPI assigned
Oct 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704297099 MI Primary

Addresses

Primary practice location

577 Michigan Ave Ste 201
Holland, MI 49423-4911

Mailing address

577 Michigan Ave Ste 201
Holland, MI 49423-4911

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190226003359 MI Practitioner - Nurse Practitioner 8123367760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Michigan State University College of Human Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

577 Michigan Ave
Suite 201
Holland, MI 49423-4911
Phone (616) 392-1816

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704297099MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital CurrentSince Jan 21, 2019 Accepting new patients
Holland Community Hospital Current Accepting new patients
Holland Community Hospital CurrentSince Jan 21, 2019 Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

577 Michigan Ave
Holland, MI 49423
Phone (616) 393-2190

577 Michigan Ave
Ste 201
Holland, MI 49423
Phone (231) 392-1816

175 S Waverly Rd
Holland, MI 49423
Phone (616) 355-3896

8300 Westpark Way
Zeeland, MI 49464
Phone (616) 748-5760

Interoperability endpoints

  • Direct secure messaging: jboven206693@epic00.corewelldirect.org
  • Direct secure messaging: jennifer.boven@holland.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1528534716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 MICHIGAN AVE STE 201",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 MICHIGAN AVE STE 201",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234911",
            "telephone_number": "616-392-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVEN",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704297099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.