Individual provider Active NPI

Amy Amanda Zuidema, NP-C

  • Family Nurse Practitioner
  • Holland, MI
National Provider Identifier
1891101515
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704228753 Issued in MI
Practice address
270 Hoover Blvd
Holland, MI 49423-3719
Phone
(616) 396-2972
Fax
(616) 396-2808
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704228753 MI Primary

Addresses

Primary practice location

270 Hoover Blvd
Holland, MI 49423-3719

Mailing address

270 Hoover Blvd
Holland, MI 49423-3719
Phone (616) 396-2972

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140826000695 MI Practitioner - Nurse Practitioner 6002034535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Noch Physician Billing Company LLCGroup PAC ID 8527078583, 7 clinicians

Practice addresses (Care Compare)

1061 S Beacon Blvd
100 Palliative Care
Grand Haven, MI 49417-2588
Phone (616) 846-2015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704228753MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Noch Physician Billing Company LLC CurrentSince Sep 8, 2020 Accepting new patients

Locations

1061 S Beacon Blvd
Ste 100
Grand Haven, MI 49417
Phone (616) 846-2015

1309 Sheldon Rd
Grand Haven, MI 49417
Phone (616) 842-3600

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1891101515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233719",
            "telephone_number": "616-396-2972",
            "fax_number": "616-396-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233719",
            "telephone_number": "616-396-2972",
            "fax_number": "616-396-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUIDEMA",
        "first_name": "AMY",
        "middle_name": "AMANDA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704228753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.