Russell Neil Vanhouzen, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301035319 Issued in MI

Practice address

10161 E Pickwick CT
Suite E
Traverse City, MI 49684-5239

Phone

(231) 935-0888

Fax

(231) 935-0890

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Russell Van Houzen, MD, PLC

  • Internal Medicine Physician
  • Traverse City, MI
  • NPI 1447460852
  NPD (past) Authorized official

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831279223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10161 E PICKWICK CT",
            "address_2": "SUITE E",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845239",
            "telephone_number": "231-935-0888",
            "fax_number": "231-935-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10161 E PICKWICK CT",
            "address_2": "SUITE E",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845239",
            "telephone_number": "231-935-0888",
            "fax_number": "231-935-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANHOUZEN",
        "first_name": "RUSSELL",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301035319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1096875",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1102810212",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corey R Vanderwulp, OT
• Robert Bruce Vandragt, DENTIST
• Audrey Vang
• Reagab Vanhaaran
• Joshua Charles Vanhorn, DDS
• Kaitlyn Joyce Vanias, M.D.
• Gary Vann, PH.D.
• Justin Allan Vanskyhock, D.C.
• Ethan S. Vantil, M. D.
• Anthony C Vanvreede

• Internal Medicine Physician in Traverse City, MI
• Providers in Traverse City, 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 Jul 8, 2007; 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.