Vijil K Rahulan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301078860 Issued in MI

Practice address

2885 Sanford Ave SW
Suite No. 18083
Grandville, MI 49418-1342

Phone

(810) 982-7243

NPI assigned

Feb 28, 2006

Last updated

Oct 30, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1710953666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 SANFORD AVE SW",
            "address_2": "SUITE NO. 18083",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181342",
            "telephone_number": "810-982-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885 SANFORD AVE SW",
            "address_2": "SUITE NO. 18083",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181342",
            "telephone_number": "810-982-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHULAN",
        "first_name": "VIJIL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301078860",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301078860",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301078860",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4485080",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren A Quiniff, LMSW
• Carly Rose Quinn, DO
• Reyna Becker Rabago, MS
• Ronald Rabineau III, D.C.
• Megan Radaz, OD
• Kirk Christopher Randall, P.T.
• Erica Rangel, LPC
• Julia Raspbury Greenspan, DLLP
• Rauser Counseling LLC
• Stacie Rayman, MSPT

• Family Medicine Physician in Grandville, MI
• Providers in Grandville, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.