Grand Haven Bone & Joint, P.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

DB067471 Issued in MI

Legal business name

GRAND HAVEN BONE & JOINT, P.C.

Practice address

1445 Sheldon Rd
Ste. G1
Grand Haven, MI 49417-2480

Phone

(616) 296-9100

Fax

(616) 296-0145

NPI assigned

Jun 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca Bakker, R.N.

Title

Office Manager

Phone

(616) 296-9100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730123506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 SHELDON RD",
            "address_2": "STE. G1",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172480",
            "telephone_number": "616-296-9100",
            "fax_number": "616-296-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 SHELDON RD",
            "address_2": "STE. G1",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172480",
            "telephone_number": "616-296-9100",
            "fax_number": "616-296-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND HAVEN BONE & JOINT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAKKER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "616-296-9100",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "DB067471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4324025",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.