Debra Bossenbroek, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704159159 Issued in MI

Practice address

1211 Lafayette Ave NE
Grand Rapids, MI 49505-5092

Phone

(616) 336-8800

Fax

(616) 336-9700

NPI assigned

Apr 23, 2007

Last updated

Jun 14, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Catherine's Health Center

  • Clinic/Center
  • Grand Rapids, MI
  • NPI 1912055872
  Medicare reassignment NPD
• Catherine's Health Center

  dba Catherine's Health Center Harrison

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1407742018
  NPD

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1649498676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 LAFAYETTE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055092",
            "telephone_number": "616-336-8800",
            "fax_number": "616-336-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 LAFAYETTE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055092",
            "telephone_number": "616-336-8800",
            "fax_number": "616-336-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSENBROEK",
        "first_name": "DEBRA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704159159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2049587",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerard Paul Bosscher Jr., DDS, MS.
• James Andrew Bosscher, LMSW
• Kate Bosscher, PHARMD
• Ryon Bosscher, D.C.
• Stephen Bossenberry, M.D.
• Nicole M. Bossenbroek, M.D.
• Shiloh Verity Bossenbroek
• Darlene J Bossingham, RN
• Jana Yasmine Boster
• Kalob Boston

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.