Active NPI
John Walstrum, MD
- Family Medicine Physician
- Allegan, MI
National Provider Identifier
1679564975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- JW042924
- Practice address
- 551 Linn St
Allegan, MI 49010-1595 - Phone
- (269) 686-5800
- Fax
- (269) 686-5899
- NPI assigned
- Nov 4, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | JW042924 | MI | Primary |
Addresses
Primary practice location
551 Linn St
Allegan, MI 49010-1595
Mailing address
551 Linn St
Allegan, MI 49010-1595
Phone (269) 686-5800
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25685 | Other | MI | COMMUNITY CHOICE OF MI |
| 080067212 | Other | RAILROAD MEDICARE | |
| 1837425 | Other | UNITED HEALTHCARE | |
| 0800300041 | Other | MI | BCBS MI PROV # |
| 20476 | Other | MI | HEALTH PLAN OF MI |
| P53510 | Other | MI | BLUE CARE NETWORK |
| 01-30460 | Other | PHP PROV # | |
| JW042924 | Other | MI | STATE LINCENSE # |
| P00361391 | Other | MI | RAILROAD MEDICARE |
| 1353542 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JW042924 | MI | MD | Family Medicine Physician |
Interoperability endpoints
- john.walstrum.p1@direct.alleganfamilyhealth.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426118400000",
"number": "1679564975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "551 LINN ST",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490101595",
"telephone_number": "269-686-5800",
"fax_number": "269-686-5899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "551 LINN ST",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490101595",
"telephone_number": "269-686-5800",
"fax_number": "269-686-5899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSTRUM",
"first_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-04",
"last_updated": "2015-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "JW042924",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY CHOICE OF MI",
"identifier": "25685",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080067212",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1837425",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MI PROV #",
"identifier": "0800300041",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF MI",
"identifier": "20476",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "P53510",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP PROV #",
"identifier": "01-30460",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LINCENSE #",
"identifier": "JW042924",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00361391",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1353542",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Allegan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.