NPIMap

Organization Active NPI

West Shore Otolaryngology PC

Doing business as West Shore ENT & Allergy Farr Rd

  • Multi-Specialty Clinic/Center
  • Norton Shores, MI
National Provider Identifier
1548764426
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
WEST SHORE OTOLARYNGOLOGY PC
Doing business as
West Shore ENT & Allergy Farr Rd
Practice address
1450 Farr Rd Ste 5000
Norton Shores, MI 49444
Phone
(231) 739-9095
Fax
(231) 722-5147
NPI assigned
Mar 23, 2018
Last updated
Jul 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Matthew A Bowen, MDNPI 1174785182
Title
President
Phone
(231) 739-9095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1450 Farr Rd Ste 5000
Norton Shores, MI 49444

Mailing address

1450 Farr Rd Ste 5000
Norton Shores, MI 49444-7789
Phone (231) 739-9095

Other practice location 1

5816 W US Highway 10
Ludington, MI 49431-2450
Phone (231) 739-9095

Other names 1

  • West Shore ENT & Allergy Farr Rd Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address westshoreentallergy@allmedsccd.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180430001754 MI Part B Supplier - Clinic/Group Practice 4284998154 Receives reassigned benefits from 11 practitioners
2 other NPIs on this enrollment
Practice locations: Fremont, MI; Grand Haven, MI; Norton Shores, MI

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1600 S Beacon Blvd
Ste 100
Grand Haven, MI 49417
Phone (614) 954-0600

1600 S Beacon Blvd
Ste 140
Grand Haven, MI 49417
Phone 2317772625 ext. 233

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1548764426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 FARR RD STE 5000",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494447789",
            "telephone_number": "231-739-9095",
            "fax_number": "231-722-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 FARR RD STE 5000",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "49444",
            "telephone_number": "231-739-9095",
            "fax_number": "231-722-5147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5816 W US Highway 10",
            "address_purpose": "LOCATION",
            "city": "Ludington",
            "state": "MI",
            "postal_code": "494312450",
            "country_code": "US",
            "telephone_number": "231-739-9095",
            "fax_number": "231-722-5147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WEST SHORE OTOLARYNGOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-739-9095",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "westshoreentallergy@allmedsccd.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1450 Farr Rd Ste 5000",
            "city": "Norton Shores",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "West Shore ENT & Allergy Farr Rd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norton Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.