Individual provider Active NPI

Jewel Wiersma

  • Rehabilitation Practitioner
  • Spring Lake, MI
National Provider Identifier
1912359092
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
15799 144TH Ave
Spring Lake, MI 49456-9539
Phone
(616) 848-6485
NPI assigned
Jul 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

15799 144TH Ave
Spring Lake, MI 49456-9539

Mailing address

15799 144TH Ave
Spring Lake, MI 49456-9539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1912359092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15799 144TH AVE",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15799 144TH AVE",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569539",
            "telephone_number": "616-848-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERSMA",
        "first_name": "JEWEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.