D H Anesthesia Services

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704113698 Issued in MI

Legal business name

D H ANESTHESIA SERVICES

Practice address

1247 Old Lake CT SE
Grand Rapids, MI 49546-4352

Phone

(269) 945-2176

Fax

(269) 945-0885

NPI assigned

Oct 12, 2007

Organization subpart

No

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

Authorized official

Name

David B Hoeksema, CRNA

Title

Owner

Phone

(269) 945-2176

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1992993174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 OLD LAKE CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495464352",
            "telephone_number": "269-945-2176",
            "fax_number": "269-945-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 OLD LAKE CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495464352",
            "telephone_number": "269-945-2176",
            "fax_number": "269-945-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D H ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "HOEKSEMA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-945-2176",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704113698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4308752770",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Certified Registered Nurse Anesthetist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.