MR. JACK DE BOER (NPI# 1750535373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750535373 |
| Entity Type | Individual |
| Full Name | MR. JACK DE BOER |
| Credential | CCC-A |
| Practice Address |
2036 Chesaning Dr Se Grand Rapids MI 49506-5309 |
| Practice Telephone | 6168193070 |
| Practice Fax Number | 6168193239 |
| Mailing Telephone | 6168193070 |
| Mailing Fax Number | 6168193239 |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2008-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | 1601000343 | MI | Speech, Language and Hearing Service Providers |
| N | 231HA2400X |
Audiologist Specialization: Assistive Technology Practitioner |
1601000342 | MI | Speech, Language and Hearing Service Providers |
| N | 237600000X | Audiologist-Hearing Aid Fitter | 1601000343 | MI | Speech, Language and Hearing Service Providers |
| Street Address |
2036 CHESANING DR SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49506-5309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954705 | Mckenna Shank | Technician | 1409 E Beltline Ave Se, Grand Rapids, MI 49506 | 2020-08-26 |
| 1750917969 | Meghan Elizabeth Southwell | Social Worker | Counseling Center of West Michigan, 360 East Beltline Ave Ne Suite 100, Grand Rapids, MI 49506 | 2020-03-19 |
| 1356876536 | Lisa Finkbeiner | Chiropractor | 1324 Lake Dr Se Ste 1, Grand Rapids, MI 49506 | 2017-04-26 |
| 1447622964 | Ashley Robinson | Rehabilitation Practitioner | 1490 East Beltline Ave, Grand Rapids, MI 49506 | 2015-10-23 |
| 1770951584 | Stuart Segal | Behavioral Analyst | 1415 Wealthy St Se Apt 312, Grand Rapids, MI 49506 | 2015-09-10 |
| 1922476373 | Elizabeth Taylor | Nurse Practitioner | 2255 Wealthy Dr., Grand Rapids, MI 49506 | 2015-09-02 |
| 1780066092 | Carole Walters Counseling | Social Worker | 959 Wealthy St. Se, Grand Rapids, MI 49506 | 2015-06-23 |
| 1053792697 | Rosemary F. Trimpe | Social Worker | 4255 Kalamazoo Se, Grand Rapids, MI 49506 | 2015-06-09 |
| 1164809919 | Gary James | Rehabilitation Practitioner | 1490 E. Beltline Se, Grand Rapids, MI 49506 | 2015-04-30 |
| 1275925315 | Paul Cole | Counselor | 1101 Ball Ave. .se., Grand Rapids, MI 49506 | 2015-02-26 |
| Find all providers in zip 49506 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143210 | Megan Justine Gustavson | Audiologist | 6140 28th St Se Ste 205, Grand Rapids, MI 49546-6938 | 2020-01-15 |
| 1730439225 | William Allen Hodgson | Audiologist | 803 Ne 1st Ave, Grand Rapids, MN 55744-2751 | 2012-09-12 |
| 1457596090 | Mary Disselkoen | Audiologist | 1353 Van Auken St Se, Grand Rapids, MI 49508-2516 | 2008-12-11 |
| 1740452200 | Susan Jane Haveman-kruyf | Audiologist | 655 Kenmoor Ave Se Ste A, Grand Rapids, MI 49546-8622 | 2008-03-25 |
| 1023299088 | Sharon K. Hickox | Audiologist | 4055 Cascade Rd Se Ste 201, Grand Rapids, MI 49546-2149 | 2007-11-19 |
| 1932329729 | Theresa Marie Bosworth | Audiologist | 1425 Michigan Ne Suite A, Grand Rapids, MI 49503 | 2007-04-26 |
| 1164575833 | Edward Joseph Szumowski | Audiologist | 4232 29th St Se, Grand Rapids, MI 49512-1936 | 2007-01-18 |
| 1093878480 | Karen Ann Jacobs | Audiologist | 5344 Plainfield Ave Ne, Suite 4, Grand Rapids, MI 49525-1009 | 2006-12-18 |
| 1588697411 | Denise Ann Hove | Audiologist | 1542 Golf Course Rd Ste 204, Grand Rapids, MN 55744-3555 | 2006-07-07 |
| 1558848374 | Karson Glass | Audiologist | 6140 28th St Se, Grand Rapids, MI 49546-6938 | 2018-07-24 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49506 |
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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.