DR. BRENT VAN TIL (NPI# 1225285992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225285992 |
| Entity Type | Individual |
| Full Name | DR. BRENT VAN TIL |
| Credential | DPM |
| Practice Address |
904 Washington Ave Ste 130 Holland MI 49423-7724 |
| Practice Telephone | 6163927472 |
| Practice Fax Number | 6163923327 |
| Mailing Telephone | 6163927472 |
| Mailing Fax Number | 6163923327 |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2013-12-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
5901002387 | MI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE | 5901002387 | 01 |
| Street Address |
904 WASHINGTON AVE STE 130 |
| City | HOLLAND |
| State | MI |
| Zip Code | 49423-7724 |
| 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 | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093219743 | Holland Community Hospital | Podiatrist | 3299 N Wellness Dr Ste 230, Holland, MI 49424-7271 | 2018-03-19 |
| 1720460629 | Jeffrey Allen Muldoon | Podiatrist | 904 S Washington Ave, Holland, MI 49423-7724 | 2015-06-26 |
| 1356684567 | Allison Beth Dozeman | Podiatrist | 904 Washington Ave, Holland, MI 49423-7724 | 2013-04-05 |
| 1225342025 | Elizabeth Ann Cherry Horton | Podiatrist | 904 Washington Ave, Holland, MI 49423-7724 | 2010-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056665 | Radu Purtuc Dpm Pllc | Podiatrist | 20005 Hidden Oaks Dr, Brownstown, MI 48183-3276 | 2020-09-03 |
| 1790300978 | Bhavik Patel | Podiatrist | 16001 W 9 Mile Rd Fl 2, Southfield, MI 48075-4818 | 2020-06-12 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1770104580 | Ali Chami | Podiatrist | 20115 River Oaks Dr, Dearborn Heights, MI 48127-2709 | 2020-05-04 |
| 1780233627 | Bloomfield Foot & Ankle Specialists Pllc | Podiatrist | 43750 Woodward Ave Ste 102, Bloomfield Hills, MI 48302-5063 | 2019-09-04 |
| 1063068435 | Monaghan Post-vasold Podiatry Plc | Podiatrist | 5377 N Waldo Rd, Midland, MI 48642-9713 | 2019-08-12 |
| 1598323909 | Lakeside Foot & Leg Care Pllc | Podiatrist | 14322 Grandview Dr, Sterling Heights, MI 48313-3447 | 2019-05-31 |
| 1285297481 | J Weber Medical Group Pllc | Podiatrist | 620 Woodmere Ave Ste C, Traverse City, MI 49686-3397 | 2019-04-15 |
| 1780182907 | Jeffrey Schwalb Dpm Pllc | Podiatrist | 5755 W Maple Rd Ste 115, W Bloomfield, MI 48322-4415 | 2018-01-23 |
| 1487193686 | Michael A. Hartman Dpm PC | Podiatrist | 12885 Northline Rd, Southgate, MI 48195-1181 | 2017-02-21 |
| Find all providers with the same taxonomy | ||||
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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.