NPIMap

Organization Active NPI

Comprehensive ENT P.C.

  • Otolaryngology Physician
  • Holland, MI
National Provider Identifier
1841468196
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301029955 Issued in MI
Legal business name
COMPREHENSIVE ENT P.C.
Practice address
111 W 24TH St
Holland, MI 49423-4791
Phone
(616) 396-2325
Fax
(616) 396-0317
NPI assigned
Feb 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Dr. Jack Wiley Delong, M.D.NPI 1356349039
Title
Ceo
Phone
(616) 396-2325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 4301029955 MI Primary

Addresses

Primary practice location

111 W 24TH St
Holland, MI 49423-4791

Mailing address

111 W 24TH St
Holland, MI 49423-4791
Phone (616) 396-2325

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1841468196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W 24TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234791",
            "telephone_number": "616-396-2325",
            "fax_number": "616-396-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W 24TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234791",
            "telephone_number": "616-396-2325",
            "fax_number": "616-396-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE ENT P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "DELONG",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "WILEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-396-2325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301029955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.