Individual provider Active NPI

John Ludlow, MD

  • Urology Physician
  • Holland, MI
National Provider Identifier
1710927728
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301072083 Issued in MI
Practice address
577 Michigan Ave
Suite 201
Holland, MI 49423-4911
Phone
(616) 392-1816
Fax
(616) 392-1292
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 75601 MN
Urology Physician 208800000X 4301072083 MI Primary

Addresses

Primary practice location

577 Michigan Ave
Suite 201
Holland, MI 49423-4911

Mailing address

PO Box 77000
Dept # 771412
Detroit, MI 48277-1412
Phone (616) 392-1816

Other identifiers 1

IdentifierTypeStateIssuer
1952507444OtherGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, MN, ND3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060203000406 MI Practitioner - UrologyPractitioner - General Practice 4880608330 Reassigns benefits to 1 organization
I20231116001508 MN Practitioner - Urology 4880608330 Reassigns benefits to 1 organization
I20240823000270 ND Practitioner - Urology 4880608330 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians
McKenzie County Healthcare Systems IncGroup PAC ID 5890768006, shared by 5 NPIs, 63 clinicians

Practice addresses (Care Compare)

577 Michigan Ave
Suite 201
Holland, MI 49423-4911
Phone (616) 392-1816

709 4TH Ave NE
Watford City, ND 58854-7628
Phone (701) 842-3000

Hospital & facility affiliations

  • McKenzie County Healthcare Systems Inc Hospital, Watford City, ND, CCN 351302
  • Holland Hospital Hospital, Holland, MI, CCN 230072
  • Sidney Health Center Hospital, Sidney, MT, CCN 271344
  • Trinity Hospitals Hospital, Minot, ND, CCN 350006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75601MNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital CurrentSince Mar 1, 2016 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Dec 1, 2024 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Dec 1, 2024 Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Sep 1, 2024 Accepting new patients
Holland Community Hospital Current Accepting new patients
St. Luke'S Hospital of Duluth Current Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Sep 1, 2024 Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Urology Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

577 Michigan Ave
Ste 201
Holland, MI 49423
Phone (231) 392-1816

1001 E Superior St
Ste 201
Duluth, MN 55802
Phone (218) 249-3057

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

1002 18th Ave SE
Ste C
Minot, ND 58701
Phone (701) 857-6010

525 N Main St
Watford City, ND 58854
Phone (701) 842-3771

709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331

1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470

Interoperability endpoints

  • Direct secure messaging: john.ludlow@holland.eclinicaldirectplus.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 9

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1710927728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77000",
            "address_2": "DEPT # 771412",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482771412",
            "telephone_number": "616-392-1816",
            "fax_number": "616-392-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 MICHIGAN AVE",
            "address_2": "SUITE 201",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234911",
            "telephone_number": "616-392-1816",
            "fax_number": "616-392-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDLOW",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "75601",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301072083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1952507444",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.