JAMES R LEBOLT (NPI# 1245331941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245331941 |
| Entity Type | Individual |
| Full Name | JAMES R LEBOLT |
| Credential | DO |
| Practice Address |
4100 Lake Dr Se Ste 300 Grand Rapids MI 49546-8292 |
| Mailing Address |
100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6162678860 |
| Practice Fax Number | 6162678442 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2016-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
5101015061 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
4100 LAKE DR SE STE 300 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366438632 | Spectrum Health Hospitals | Clinic/Center | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2005-09-22 |
| 1073146411 | James Walejewski | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2020-02-13 |
| 1811458557 | Michelle Kuzma | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2019-03-26 |
| 1063943991 | Maggie Anstett | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2017-03-22 |
| 1851746671 | Luke Murray | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2016-04-29 |
| 1942665237 | Alyssa Susanne Baker | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2015-12-31 |
| 1619332806 | Elizabeth Albert | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2015-12-15 |
| 1609247618 | Rebecca Preston | Psychologist | 4100 Lake Dr Se, Suite B01, Grand Rapids, MI 49546-8292 | 2015-10-16 |
| 1255708921 | Timothy Glerum | Nurse Practitioner | 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 | 2015-08-28 |
| 1730556796 | Samantha Ford | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2015-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215075106 | Carl Henry Wierks | Orthopaedic Surgery | 1000 E Paris Ave Se Ste 215, Grand Rapids, MI 49546-3680 | 2007-02-02 |
| 1003909524 | Mfb Professional Services Inc | Orthopaedic Surgery | 1155 E. Paris, Ste 200, Grand Rapids, MI 49546 | 2006-10-02 |
| 1578509303 | John H Healey Jr. | Orthopaedic Surgery | 350 Lafayette Ave Se, Fourth Floor, Grand Rapids, MI 49503-4656 | 2006-06-21 |
| 1730125428 | Timothy D Henne | Orthopaedic Surgery | 350 Lafayette Ave Se, 5th Floor, Grand Rapids, MI 49503-4656 | 2006-06-21 |
| 1932174109 | Michigan Orthopaedics and Sports Medicine, PC | Orthopaedic Surgery | 2911 Knapp St Ne, Suite A, Grand Rapids, MI 49525 | 2006-02-21 |
| 1720076219 | Peter C Theut | Orthopaedic Surgery | 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406 | 2005-10-10 |
| 1700873874 | Thomas M Matelic | Orthopaedic Surgery | 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406 | 2005-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821472861 | Oakland University | Orthopaedic Surgery | 201 Athletics Ctr, Rochester, MI 48309 | 2015-07-18 |
| 1689871576 | Stacy Ann Frye | Orthopaedic Surgery | 3960 Patient Care Dr Ste 113, Lansing, MI 48911-4279 | 2007-07-02 |
| 1598878266 | Abdallah Simaika | Orthopaedic Surgery | 2797 Applegate Rd, Po Box 55, Applegate, MI 48401-9752 | 2006-08-16 |
| 1689662405 | Richard M Howell | Orthopaedic Surgery | 370 N 120th Ave, Holland, MI 49424-2196 | 2005-10-06 |
| 1235121138 | Steven T Plomaritis | Orthopaedic Surgery | 28001 Schoenherr Rd, Suite 3, Warren, MI 48088-4396 | 2005-08-17 |
| 1457961716 | Justin Michael Schupbach | Orthopaedic Surgery | 24 Frank Lloyd Wright Dr Lbby A, Ann Arbor, MI 48105-9484 | 2020-08-03 |
| 1053945923 | Pure Performance Orthopedics & Sports Medicine | Orthopaedic Surgery | 27207 Lahser Rd Ste 108, Southfield, MI 48034-2168 | 2020-02-28 |
| 1396377131 | Msu Health Care Inc. | Orthopaedic Surgery | 4660 S Hagadorn Rd Ste 420, East Lansing, MI 48823-5353 | 2020-02-10 |
| 1477011591 | Shannon Elizabeth Manno | Orthopaedic Surgery | 26850 Providence Pkwy Ste 260, Novi, MI 48374-1256 | 2019-03-07 |
| 1659895993 | Alexander S Russell | Orthopaedic Surgery | 2799 W Grand Blvd, Detroit, MI 48202 | 2017-07-28 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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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.