Innovative Health at Home

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

INNOVATIVE HEALTH AT HOME

Practice address

560 Seminole Rd
Norton Shores, MI 49444-3720

Phone

(231) 733-3525

NPI assigned

Jan 16, 2020

Organization subpart

No

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

Authorized official

Name

Kimberly Joan Vazquez

Title

Medical Services Administrator

Phone

(231) 733-3525

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1831729086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 SEMINOLE RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 SEMINOLE RD",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494443720",
            "telephone_number": "231-733-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE HEALTH AT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-16",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "MEDICAL SERVICES ADMINISTRATOR",
        "authorized_official_telephone_number": "231-733-3525"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Hurtubise, MA, LBA, BCBA
• Robert G Hylland, M.D.
• Erin Iaaco
• Ideal Dentistry of Norton Shores
• Kayleen Ingalls
• Tiffany Jackson-Kitchens
• Jacob M. Fischer DDS PLLC
• Megan Nicole Jahnke
• Annika Jaros
• Krystle Monique' Jefferson

• Gerontology Nurse Practitioner in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.