12TH Street PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

12TH STREET PLLC

Doing business as

12th Street Internal Medicine and Pediatrics

Practice address

3587 12TH St
Wayland, MI 49348-9569

Phone

(616) 648-4933

NPI assigned

Apr 7, 2023

Last updated

Aug 15, 2023By 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

Joel Veldhouse, MDNPI 1659685741

Title

Physician Owner

Phone

(616) 648-4933

Specialties & licenses 2

Addresses

Other names 1

• 12th Street Internal Medicine and Pediatrics Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

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

Practitioners 4

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.

• Joel Patrick Veldhouse, M.D.

  • Internal Medicine Physician
  • Wayland, MI
  • NPI 1659685741
  Medicare reassignment Care Compare group NPD Authorized official
• Linnelle Anne Veldhouse, MD

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1366679961
  Medicare reassignment Care Compare group NPD
• Lisa Marie Striegle, APRN

  • Family Nurse Practitioner
  • Kentwood, MI
  • NPI 1770904229
  Medicare reassignment NPD
• Gary Byron Gulish, D.O.

  • Family Medicine Physician
  • Wayland, MI
  • NPI 1376572131
  NPD

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1790470409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 12TH ST",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493489569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3587 12TH ST",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493489569",
            "telephone_number": "616-648-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "12TH STREET PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "VELDHOUSE",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "616-648-4933",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "12th Street Internal Medicine and Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "12th Street Internal Medicine and Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christine Laura Ackermann, D.D.S.
• Advanced Health Solutions & Staffing, LLC (Be-Well Health)
• Advantage DX
• Amazing Center LLC
• Muriel Ann Arrowsmith, FNP

• Internal Medicine Physician in Wayland, MI
• Providers in Wayland, 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 Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.