NPIMap

Organization Active NPI

County of Ottawa

  • Non-Surgical Family Planning Clinic/Center
  • Holland, MI
National Provider Identifier
1679653422
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Surgical Family Planning Clinic/CenterTaxonomy code 261QF0050X
Legal business name
COUNTY OF OTTAWA
Practice address
12251 James St
Suite 400
Holland, MI 49424-9675
Phone
(616) 393-5781
Fax
(616) 393-5643
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Mrs. Lisa Stefanovsky
Title
Health Officer
Phone
(616) 393-5781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Surgical Family Planning Clinic/Center 261QF0050X MI Primary

Addresses

Primary practice location

12251 James St
Suite 400
Holland, MI 49424-9675

Mailing address

12251 James St
Suite 400
Holland, MI 49424-9675
Phone (616) 393-5781

Other identifiers 4

IdentifierTypeStateIssuer
5100822MedicaidMI
1678314MedicaidMI
1678299MedicaidMI
5100813MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090930000715 MI Part B Supplier - Mass Immunization (Roster Biller Only) 0042118036 Practice locations: Grand Haven, MI; Holland, MI; Hudsonville, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Ottawa

    dba Ottawa County Community Mental Health

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Holland, MI
    • NPI 1619932381

    0042118036

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
County of Ottawa14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

16920 Ferris St
Grand Haven, MI 49417
Phone (616) 846-8360

12251 James St
Ste 400
Holland, MI 49424
Phone (616) 393-5781

12251 James St
Holland, MI 49424
Phone (616) 368-0575

12251 James St
Ste 500
Holland, MI 49424
Phone (616) 393-5266

Practitioners & affiliated clinicians

Practitioners 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1679653422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 JAMES ST",
            "address_2": "SUITE 400",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249675",
            "telephone_number": "616-393-5781",
            "fax_number": "616-393-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 JAMES ST",
            "address_2": "SUITE 400",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249675",
            "telephone_number": "616-393-5781",
            "fax_number": "616-393-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF OTTAWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "STEFANOVSKY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "616-393-5781",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100822",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1678314",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1678299",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5100813",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.