Gerald E. Van Wieren, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

042527 Issued in MI

Practice address

71 S Front St
Grant, MI 49327-9701

Phone

(231) 834-5676

Fax

(231) 834-7211

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1780682252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 S FRONT ST",
            "city": "GRANT",
            "state": "MI",
            "postal_code": "493279701",
            "telephone_number": "231-834-5676",
            "fax_number": "231-834-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 S FRONT ST",
            "city": "GRANT",
            "state": "MI",
            "postal_code": "493279701",
            "telephone_number": "231-834-5676",
            "fax_number": "231-834-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WIEREN",
        "first_name": "GERALD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "042527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2924566",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brett J Stacer, PA
• Amanda Jean Stroven
• Debbie Symon, RDH
• Zenn Timmer, LMSW
• Andrew Valdez, RDH
• Suzanne M. Van Wieren, F.N.P.
• James Peter Vanhuisen, DPT
• Linda Ann Velding, COTA
• Michael John Vokits, RPH
• Amber Marie Ward

• Internal Medicine Physician in Grant, MI
• Providers in Grant, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.