NPIMap

Organization Active NPI

White Pine Family Medicine

  • Physician Assistant
  • Cedar Springs, MI
National Provider Identifier
1740234236
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002704 Issued in MI
Legal business name
WHITE PINE FAMILY MEDICINE
Practice address
261 N Main
Cedar Springs, MI 49319-9709
Phone
(616) 696-2020
Fax
(616) 696-4860
NPI assigned
May 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Denise R Wilholt, RT(R)
Title
Practice Manager
Phone
69166962020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002704 MI Primary

Addresses

Primary practice location

261 N Main
Cedar Springs, MI 49319-9709

Mailing address

261 N Main
PO Box 221K
Cedar Springs, MI 49319-9709
Phone (616) 696-2020

Other identifiers 1

IdentifierTypeStateIssuer
4737787MedicaidMI

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGAFAA

Practitioners & affiliated clinicians

Practitioners 11

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": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740234236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N MAIN",
            "address_2": "PO BOX 221K",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "493199709",
            "telephone_number": "616-696-2020",
            "fax_number": "616-696-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N MAIN",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "493199709",
            "telephone_number": "616-696-2020",
            "fax_number": "616-696-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE PINE FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILHOLT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "69166962020",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RT(R)"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4737787",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Springs, MI

Sources for this page

  • 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.