Jenna Maki, AT, ATC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

2601001590 Issued in MI

Practice address

602 Michigan Ave
Holland, MI 49423-4918

Phone

(616) 392-5141

NPI assigned

Oct 19, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1891166690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 COUNTS COVE CT",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242592",
            "telephone_number": "616-994-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918",
            "telephone_number": "616-392-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKI",
        "first_name": "JENNA",
        "credential": "AT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MI",
            "license": "2601001590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas L Maguire, DPM
• Tracy Marie Maher, LLP
• Brittany Angel Mailloux-Kross, DDS
• Lee Majeski, NP
• Jordyn Olivia Maka
• Maletta Chiropractic PLLC
• Phillip Maletta, DC
• Richard Albert Malmsten, PA
• Emily Lauren Malvar, AGNP, DNP
• Arben S Mandija, PT

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Holland, MI
• Providers in Holland, MI by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.