GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC


Address: 1159 S Harbor Dr, Suite C-4, Grand Haven, MI 49417-1777
Phone: 6168444067

GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC (NPI# 1609810985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609810985
Entity Type Organization
Organization Name GERIATRIC & EXTENDED REHABILITATION MEDICINE LLC
Practice Address 1159 S Harbor Dr
Suite C-4
Grand Haven
MI 49417-1777
Mailing Address 1159 S Harbor
C4
Grand Haven
MI 49417-1777
Practice Telephone 6168444067
Practice Fax Number 6168444067
Mailing Telephone 6168444067
Mailing Fax Number 6168444067
Enumeration Date 2006-06-16
Last Update Date 2011-10-04
Authorized Official Name DONALD EZRA RUTHERFORD (OWNER PRESIDENT)
Authorized Official Telephone 6168444067
Authorized Official Credential D.O.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QG0300X Family Medicine
Specialization: Geriatric Medicine
5101009705 MI Allopathic & Osteopathic Physicians

Office Location

Street Address 1159 S HARBOR DR
SUITE C-4
City GRAND HAVEN
State MI
Zip Code 49417-1777

Providers in the same location

NPI Name Taxonomy Address Enumeration
1811961899 Donald Ezra Rutherford Family Medicine 1159 S Harbor Dr, Suite C4, Grand Haven, MI 49417-1796 2006-02-15

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295393478 Compassionate Christian Therapy, LLC Social Worker 16989 Robbins Rd, Grand Haven, MI 49417 2019-06-03
1275098501 Christi Rene Fortenbacher Massage Therapist 318 S. Beacon Blvd, Grand Haven, MI 49417 2019-01-31
1518440650 Jessica Hankins Physical Therapy Assistant 15773 Charles Ct, Grand Haven, MI 49417 2018-09-14
1558857466 Christina Steege Physical Therapist 514 Friant St, Grand Haven, MI 49417 2018-07-03
1851822548 Forefront Dermatology, S.c. Dermatology 1600 S Beacon Blvd, Suite 160, Grand Haven, MI 49417 2017-03-23
1982057907 Jeremyn Duane Wiersma Counselor 1703 S. Despelder St., Grand Haven, MI 49417 2016-07-14
1760855225 Lisa Costello Dental Hygienist 326 N. Ferry St, Grand Haven, MI 49417 2015-11-05
1508116088 Great Lakes Chiropractic Health Chiropractor 15 S. Seventh St., Grand Haven, MI 49417 2012-09-12
1508120122 Jonathan Stewart Rouwhorst Family Medicine 15161 Willowwood Ct, Grand Haven, MI 49417 2012-06-28
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Taxonomy Information

Taxonomy Code 207QG0300X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Geriatric Medicine

Taxonomy Definition

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1124651435 Navihealth Michigan Hbpc, PC Family Medicine 2 Towne Sq Ste 275, Southfield, MI 48076-3719 2020-02-14
1215481981 Metro Physicians Pllc Family Medicine 5555 Conner St Ste 2075, Detroit, MI 48213-3492 2016-08-10
1447610704 Provider Service Organization Family Medicine 7233 Provincial Ct, Canton, MI 48187-2121 2016-02-29
1659704633 David Gordon Reed Family Medicine 3620 Chula Vista Dr, East Jordan, MI 49727-8629 2013-08-14
1174800411 New Life Medical Senior Care PC Family Medicine 105 S Wildwood Xing Apt 20, Ludington, MI 49431-8719 2011-11-15
1306134085 Jeremiah Lopez Family Medicine 804 Service Rd Ste A235, East Lansing, MI 48824-7015 2011-07-15
1770819344 Midmichigan Geriatric Services Pllc Family Medicine 4823 Henry Dr, Saginaw, MI 48638-5631 2009-11-02
1982871265 Daniel R Smalley Family Medicine 105 S Wildwood Crossing 20, Ludington, MI 49431-8719 2008-05-15
1821267832 Eastlake Medical Center Family Medicine 646 Chene St, Detroit, MI 48207-3979 2008-02-23
1740479278 William Kerr Md PC Family Medicine 650 N Center Ave, Suite 3 B, Gaylord, MI 49735-1682 2007-10-22
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Competitor

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City GRAND HAVEN
Zip Code 49417

Improve Information

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Dataset Information

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.

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