NPIMap

Organization Active NPI

Age Management and Hormone Balance Center

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1730417288
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301076867 Issued in MI
Legal business name
AGE MANAGEMENT AND HORMONE BALANCE CENTER
Practice address
1787 Grand Ridge CT NE
Suite 202
Grand Rapids, MI 49525-7042
Phone
(616) 808-2695
Fax
(616) 808-2697
NPI assigned
Nov 20, 2009
Last updated
Sep 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Authorized official

Name
Piyush Bhatnagar, M.D.NPI 1811961907
Title
Internist-Managing Director
Phone
(616) 808-2695

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301076867 MI Primary

Addresses

Primary practice location

1787 Grand Ridge CT NE
Suite 202
Grand Rapids, MI 49525-7042

Mailing address

1787 Grand Ridge CT NE
Suite 202
Grand Rapids, MI 49525-7042
Phone (616) 808-2695

National Provider Directory

National Provider Directory
Tax ID family
Age Management and Hormone Balance Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1787 Grand Ridge Ct NE
Ste 202
Grand Rapids, MI 49525
Phone (616) 808-2695

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1730417288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1787 GRAND RIDGE CT NE",
            "address_2": "SUITE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257042",
            "telephone_number": "616-808-2695",
            "fax_number": "616-808-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 GRAND RIDGE CT NE",
            "address_2": "SUITE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257042",
            "telephone_number": "616-808-2695",
            "fax_number": "616-808-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGE MANAGEMENT AND HORMONE BALANCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-20",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "BHATNAGAR",
        "authorized_official_first_name": "PIYUSH",
        "authorized_official_title_or_position": "INTERNIST-MANAGING DIRECTOR",
        "authorized_official_telephone_number": "616-808-2695",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301076867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.