Individual provider Active NPI

James Tegart Bishop, M.D.

  • Otolaryngic Allergy Physician
  • Holland, MI
National Provider Identifier
1922001791
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
4301033824 Issued in MI
Practice address
388 Garden Ave
Ste 100
Holland, MI 49424-7186
Phone
(616) 393-0567
Fax
(616) 393-0562
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X 4301033824 MI Primary

Addresses

Primary practice location

388 Garden Ave
Ste 100
Holland, MI 49424-7186

Mailing address

388 Garden Ave
Ste 100
Holland, MI 49424-8998
Phone (616) 393-0567

Other identifiers 2

IdentifierTypeStateIssuer
2779821MedicaidMI
0407054001OtherMIBCBS

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)
Enrolled
Credentials
Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1922001791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 GARDEN AVE",
            "address_2": "STE 100",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248998",
            "telephone_number": "616-393-0567",
            "fax_number": "616-393-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 GARDEN AVE",
            "address_2": "STE 100",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494247186",
            "telephone_number": "616-393-0567",
            "fax_number": "616-393-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "JAMES",
        "middle_name": "TEGART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MI",
            "license": "4301033824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2779821",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0407054001",
            "state": "MI"
        }
    ],
    "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 Oct 15, 2012; 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.