Kent Otolaryngology Associates, P.C.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

4301030445 Issued in MI

Legal business name

KENT OTOLARYNGOLOGY ASSOCIATES, P.C.

Practice address

222 Fulton St E
Grand Rapids, MI 49503-3211

Phone

(616) 459-7455

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Thomas Spooner, MD

Title

President

Phone

(616) 459-7455

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Marie Bosworth, MA,CCC-A

  • Audiologist
  • Grand Rapids, MI
  • NPI 1932329729
  NPD (past)
• William A Scalf, MD

  • Otolaryngology Physician
  • Battle Creek, MI
  • NPI 1306802657
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659591204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 FULTON ST E",
            "address_2": "PO BOX 1983",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033211",
            "telephone_number": "616-459-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 FULTON ST E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033211",
            "telephone_number": "616-459-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT OTOLARYNGOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPOONER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-459-7455",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301030445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1120578",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kent County CMH Authority (Network 180)
• Kent Family Dental Care
• Kent Integrated Health Network PLLC
• Kent Intermediate School District
• Kent Neurological Associates PC
• Kent Pathologists PLLC
• Kent Pathology Laboratory PLLC
• Kent Pathology Laboratory PLLC
• Kent Podiatry
• Kent R Wildern DDS PC

• Otolaryngology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.