Melissa Kathy Koekkoek, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

4301108856 Issued in MI

Practice address

1670 E Sherman Blvd
Muskegon, MI 49444-1863

Phone

(231) 672-2400

Fax

(231) 672-2401

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Interoperability endpoints

• Direct secure messaging: mlinner37125@direct.trinity-health.org

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.

• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1720176290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441863",
            "telephone_number": "231-672-2400",
            "fax_number": "231-672-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441863",
            "telephone_number": "231-672-2400",
            "fax_number": "231-672-2401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "590 S Main St",
            "address_purpose": "LOCATION",
            "city": "Snowflake",
            "state": "AZ",
            "postal_code": "859375228",
            "country_code": "US",
            "telephone_number": "928-536-7519",
            "fax_number": "928-536-7305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOEKKOEK",
        "first_name": "MELISSA",
        "middle_name": "KATHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MI",
            "license": "4301108856",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "36066",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Wayne Knight, DO
• Knollview SNF, LLC
• Benjamin D Knopf, PT, DPT
• Holly L Knowles, PA-C
• Yumiko T Knudson, MD
• Deirdre Kohley
• Wayne H Kohn, D.O.
• Joanne Louise Kolean, PH.D.
• Amber Nicole Kolla, P.A.
• Jeffrey A. Kommit, DO

• Adult Medicine Physician in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Adult Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.