Individual provider Active NPI

Jeremy Marc Tenbrink, FNP

  • Nurse Practitioner
  • Holland, MI
National Provider Identifier
1659084622
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704280522 Issued in MI
Practice address
577 Michigan Ave Ste 202
Holland, MI 49423-4911
Phone
(616) 394-5088
NPI assigned
Jan 4, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704280522 MI Primary

Addresses

Primary practice location

577 Michigan Ave Ste 202
Holland, MI 49423-4911

Mailing address

577 Michigan Ave Ste 202
Holland, MI 49423-4911

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230224002176 MI Practitioner - Nurse Practitioner 8325411101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

577 Michigan Ave
Holland, MI 49423-4911

602 Michigan Ave
Holland, MI 49423-4918
Phone (616) 392-5141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704280522MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital CurrentSince Feb 27, 2023 Accepting new patients
Holland Community Hospital Current Accepting new patients
Holland Community Hospital Nurse Practitioner CurrentSince Feb 27, 2023 Accepting new patients
Holland Community Hospital Nurse Practitioner Past Accepting new patients

Locations

415 Wiley Rd
Ste 102
Douglas, MI 49406
Phone (269) 857-3208

577 Michigan Ave
Ste 202
Holland, MI 49423
Phone (616) 394-0673

577 Michigan Ave
Holland, MI 49423
Phone (616) 393-2190

577 Michigan Ave
Ste 101
Holland, MI 49423
Phone (616) 393-2190

Interoperability endpoints

  • Direct secure messaging: jeremy.tenbrink@holland.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1659084622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 MICHIGAN AVE STE 202",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 MICHIGAN AVE STE 202",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234911",
            "telephone_number": "616-394-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENBRINK",
        "first_name": "JEREMY",
        "middle_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704280522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.