Liberty Belle Shelton Hoberman, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301068128 Issued in MI

Practice address

400 136TH Ave
Suite 416
Holland, MI 49424-2923

Phone

(616) 738-0470

Fax

(616) 738-0498

NPI assigned

Apr 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lakeshore Surgical Associates PC

  • Surgery Physician
  • Holland, MI
  • NPI 1013973585
  NPD (past)

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1538123724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 136TH AVE",
            "address_2": "SUITE 416",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242923",
            "telephone_number": "616-738-0470",
            "fax_number": "616-738-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 136TH AVE",
            "address_2": "SUITE 416",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242923",
            "telephone_number": "616-738-0470",
            "fax_number": "616-738-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBERMAN",
        "first_name": "LIBERTY BELLE",
        "middle_name": "SHELTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301068128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "020G010060",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4783476",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "382809956",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Analisia Hines
• Rebecca Hirt, LLPC
• His Healing Is Surrender Therapy PLLC
• Nicholas W Hite, PHARM.D.
• Kelly Marie Hobby
• Noah Benjamin Hochstetler, DO
• Taylor Hodge
• Trisha Renee Hoekenga, PTA
• Mary Ann Hoekje Gonzalez, MS, LLPC, NCC
• Hillichien W Hoekman, MD

• Surgery Physician in Holland, MI
• Providers in Holland, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; 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.