TOD WYN (NPI# 1073537403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073537403 |
| Entity Type | Individual |
| Full Name | TOD WYN |
| Credential | MD |
| Practice Address |
270 Hoover Blvd Holland MI 49423-3719 |
| Practice Telephone | 6163962972 |
| Practice Fax Number | 6163962808 |
| Mailing Telephone | 6163962972 |
| Mailing Fax Number | 6163962808 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
4301060023 | MI | Allopathic & Osteopathic Physicians |
| N | 207PH0002X |
Emergency Medicine Specialization: Hospice and Palliative Medicine |
4301060023 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | RAILROAD MEDICARE | 930017975 | 01 |
| MI | BCBS | TW060023 | 01 |
| Street Address |
270 HOOVER BLVD |
| City | HOLLAND |
| State | MI |
| Zip Code | 49423-3719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194792259 | Hospice of Holland, Inc | Hospice Care, Community Based | 270 Hoover Blvd, Holland, MI 49423-3719 | 2006-03-07 |
| 1245723246 | Kelly R Howard | Nurse Practitioner | 270 Hoover Blvd, Holland, MI 49423-3719 | 2018-06-13 |
| 1912453465 | Katie Norman | Nurse Practitioner | 270 Hoover Blvd, Holland, MI 49423-3719 | 2016-08-25 |
| 1881045839 | Lizabeth Shannon Giles | Family Medicine | 270 Hoover Blvd, Holland, MI 49423-3719 | 2016-06-30 |
| 1891101515 | Amy Amanda Zuidema | Nurse Practitioner | 270 Hoover Blvd, Holland, MI 49423-3719 | 2014-07-02 |
| 1003243908 | Hospice of Holland, Inc. | Internal Medicine | 270 Hoover Blvd, Holland, MI 49423-3719 | 2013-10-09 |
| 1033397161 | Cindy Derrer Lucas | Social Worker | 270 Hoover Blvd, Holland, MI 49423-3719 | 2008-01-31 |
| 1174692420 | Alice M Emery | Internal Medicine | 270 Hoover Blvd, Holland, MI 49423-3719 | 2006-11-08 |
| 1609955855 | Melissa Sue Roessing | Social Worker | 270 Hoover Blvd, Holland, MI 49423-3719 | 2006-11-06 |
| 1609951359 | Sally Beth Pelon | Social Worker | 270 Hoover Blvd, Holland, MI 49423-3719 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996714 | Ella Rose Marx | Social Worker | 412 Century Lane, Holland, MI 49423 | 2019-08-02 |
| 1245720424 | Amanda Ann Allen | Behavior Technician | 165 Sorrento Drive, Holland, MI 49423 | 2018-05-14 |
| 1588194237 | Emily Amila Geurink | Physical Therapy Assistant | 4037 43rd St, Holland, MI 49423 | 2017-06-15 |
| 1285081737 | Kara Draayer | Nurse Anesthetist, Certified Registered | 25 W 8th St Ste 200, Holland, MI 49423 | 2016-05-14 |
| 1851776413 | Sara Ty | Occupational Therapist | 789 South Meadow Court, Holland, MI 49423 | 2015-07-24 |
| 1508243056 | Andrew Peasley | Chiropractor | 436 Century Ln., Holland, MI 49423 | 2015-05-05 |
| 1437536497 | Deborah Donnelly | Physical Therapy Assistant | 1221 16th Street, Holland, MI 49423 | 2015-04-29 |
| 1366846024 | John Nguyen | Pharmacist | 747 E 16th St, Holland, MI 49423 | 2014-10-09 |
| 1003257817 | Courtney Young | Social Worker | 96 W 15 Street Midtown Center- Arbor Circle, Holland, MI 49423 | 2013-07-09 |
| 1689014391 | Jason Pettet | Acupuncturist | 500 West 17th St., Holland, MI 49423 | 2013-06-26 |
| Find all providers in zip 49423 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528122017 | Kenneth Kuper | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423 | 2006-12-20 |
| 1629180823 | Brian Holt | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423-4918 | 2006-08-31 |
| 1063521011 | William Carl Harris | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423 | 2006-08-30 |
| 1811921414 | David Johns | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423 | 2006-07-10 |
| 1619912540 | Boyd Evan Kroeze | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423-4918 | 2006-06-17 |
| 1679516058 | Brian John Cote | Emergency Medicine | 3232 N Wellness Dr, Holland, MI 49424-8027 | 2006-06-14 |
| 1093760134 | Kerry Lynne Vegter | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423 | 2006-05-24 |
| 1417902024 | Sandip Ujamlal Kothari | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423 | 2006-05-23 |
| 1710932546 | Douglas James Hoey | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423 | 2006-05-23 |
| 1609821081 | Michael Robert Page | Emergency Medicine | 602 Michigan Ave, Holland, MI 49423 | 2006-05-23 |
| Find all providers in HOLLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.