DR. THEODORE S VANDERVEEN (NPI# 1255351250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255351250 |
| Entity Type | Individual |
| Full Name | DR. THEODORE S VANDERVEEN |
| Credential | M.D. |
| Practice Address |
577 Michigan Ave Suite 101 Holland MI 49423-4911 |
| Practice Telephone | 6163932190 |
| Practice Fax Number | 6163930147 |
| Mailing Telephone | 6163932190 |
| Mailing Fax Number | 6163930147 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 4301028095 | MI | Allopathic & Osteopathic Physicians |
| N | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
4301028095 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS | OG06056 | 01 |
| MI | 5177354 | 05 |
| Street Address |
577 MICHIGAN AVE SUITE 101 |
| City | HOLLAND |
| State | MI |
| Zip Code | 49423-4911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497562 | Douglas Walvoord | Urology | 577 Michigan Ave, Ste 201, Holland, MI 49423-4911 | 2005-06-17 |
| 1508249129 | Grace Lee | Audiologist | 577 Michigan Ave, Suite 101, Holland, MI 49423-4911 | 2015-07-01 |
| 1265840425 | Holland Community Hospital | Internal Medicine | 577 Michigan Ave, Suite 203, Holland, MI 49423-4911 | 2014-07-31 |
| 1962742981 | Holland Hospital | Surgery | 577 Michigan Ave, Suite #202, Holland, MI 49423-4911 | 2013-02-28 |
| 1306123351 | Holland Community Hospital | Surgery | 577 Michigan Ave, Suite 202, Holland, MI 49423-4911 | 2011-11-04 |
| 1982910857 | Holland Community Hospital | Otolaryngology | 577 Michigan Ave, Suite 101, Holland, MI 49423-4911 | 2010-08-30 |
| 1639495690 | Peter Klaas Hoekman | Otolaryngology | 577 Michigan Ave, Suite 101, Holland, MI 49423-4911 | 2010-04-15 |
| 1508095530 | Holland Community Hospital | Psychiatry & Neurology | 577 Michigan Ave, Suite 203, Holland, MI 49423-4911 | 2009-07-12 |
| 1659519296 | Christina A Johnston | Psychiatry & Neurology | 577 Michigan Ave, Suite 203, Holland, MI 49423-4911 | 2009-02-03 |
| 1902065287 | Jessica Hafner | Surgery | 577 Michigan Ave, Suite 202, Holland, MI 49423-4911 | 2008-06-03 |
| 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 | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902059504 | Timothy John Mcdonald | Otolaryngology | 577 Michigan Ave Ste 101, Holland, MI 49423-4911 | 2008-10-28 |
| 1427056118 | Donald Leroy Stageman | Otolaryngology | 926 S Washington Ave, Bldg D Ste 230, Holland, MI 49423-7725 | 2005-07-07 |
| 1245549419 | Spectrum Health Primary Care Partners | Otolaryngology | 3232 N Wellness Dr, Holland, MI 49424-8027 | 2010-10-05 |
| 1982910857 | Holland Community Hospital | Otolaryngology | 577 Michigan Ave, Suite 101, Holland, MI 49423-4911 | 2010-08-30 |
| 1972819134 | D L Stageman Md Plc | Otolaryngology | 926 Washington Ave, Bld D Ste 230, Holland, MI 49423-7725 | 2010-08-26 |
| 1639495690 | Peter Klaas Hoekman | Otolaryngology | 577 Michigan Ave, Suite 101, Holland, MI 49423-4911 | 2010-04-15 |
| 1205093432 | Michigan Medical Patient Care | Otolaryngology | 3232 N Wellness Dr, Holland, MI 49424-8027 | 2008-05-16 |
| 1841468196 | Comprehensive Ent P.C. | Otolaryngology | 111 W 24th St, Holland, MI 49423-4791 | 2008-02-20 |
| 1447456934 | Hh Services Stageman LLC | Otolaryngology | 602 Michigan Ave, Holland, MI 49423-4918 | 2007-06-22 |
| 1508061722 | Nathan L Salinas | Otolaryngology | 577 Michigan Ave, Suite 101, Holland, MI 49423-4911 | 2007-06-18 |
| 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.