Geriatric & Extended Rehabilitation Medicine LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

5101009705 Issued in MI

Legal business name

GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC

Practice address

1159 S Harbor Dr
Suite C-4
Grand Haven, MI 49417-1777

Phone

(616) 844-4067

Fax

(616) 844-4067

NPI assigned

Jun 16, 2006

Last updated

Oct 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donald Ezra Rutherford, D.O.NPI 1811961899

Title

Owner President

Phone

(616) 844-4067

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Donald Ezra Rutherford, D.O.

  • Family Medicine Physician
  • Grand Haven, MI
  • NPI 1811961899
  Authorized official Same address or phone
• Nancy Lane Schultz, N.P.

  • Nurse Practitioner
  • Muskegon, MI
  • NPI 1588638589
  NPD (past)
• Gisselle Adonay Turman, P.A.

  • Physician Assistant
  • Kalamazoo, MI
  • NPI 1760457568
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1609810985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 S HARBOR",
            "address_2": "C4",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171777",
            "telephone_number": "616-844-4067",
            "fax_number": "616-844-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 S HARBOR DR",
            "address_2": "SUITE C-4",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171777",
            "telephone_number": "616-844-4067",
            "fax_number": "616-844-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "RUTHERFORD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "EZRA",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "616-844-4067",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "5101009705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Gantjos, SLP
• Kristin Anne Garling, MA, CCC-SLP
• Denise Garvey, LMSW
• Emily Gebolys
• Cynthia Geneva, OD
• Marc L Giant
• Alyssa Lynn Gillette, NP
• Julie Golin, MA, LLP
• Goodwill Optical LLC (Goodwill Optical)
• Micah Gordon

• Geriatric Medicine (Family Medicine) Physician in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Geriatric Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.