Active NPI
Laura Kooy
- Physician Assistant
- Wyoming, MI
National Provider Identifier
1548377708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003417
- Practice address
- 585 36TH St SW
Wyoming, MI 49509-4002 - Phone
- (616) 531-1871
- NPI assigned
- Aug 24, 2006
- Last updated
- Feb 1, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003417 | MI | Primary |
Addresses
Primary practice location
585 36TH St SW
Wyoming, MI 49509-4002
Mailing address
585 36TH St SW
Wyoming, MI 49509-4002
Phone (616) 531-1871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003417 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517443200000",
"number": "1548377708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 36TH ST SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495094002",
"telephone_number": "616-531-1871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 36TH ST SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495094002",
"telephone_number": "616-531-1871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOOY",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2018-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.