NPIMap

Organization Active NPI

Holland Pediatric Associates, PLC

  • Specialist
  • Holland, MI
National Provider Identifier
1912970922
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HOLLAND PEDIATRIC ASSOCIATES, PLC
Practice address
926 S. Washington Ave
Building C
Holland, MI 49423-7725
Phone
(616) 393-0166
Fax
(616) 393-8821
NPI assigned
Feb 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Authorized official

Name
Lisa Vandenbosch
Title
Administrative Coordinator
Phone
(616) 393-0166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

926 S. Washington Ave
Building C
Holland, MI 49423-7725

Mailing address

926 S. Washington Ave
Building C
Holland, MI 49423-7725
Phone (616) 393-0166

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0704358Holland Pediatric Associates PLC926 South Washington Avenue, Holland, MI 49423Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1912970922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 S. WASHINGTON AVE",
            "address_2": "BUILDING C",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237725",
            "telephone_number": "616-393-0166",
            "fax_number": "616-393-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 S. WASHINGTON AVE",
            "address_2": "BUILDING C",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237725",
            "telephone_number": "616-393-0166",
            "fax_number": "616-393-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLAND PEDIATRIC ASSOCIATES, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "VANDENBOSCH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATIVE COORDINATOR",
        "authorized_official_telephone_number": "616-393-0166"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "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 Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.