KEVIN JOHN BOLAK (NPI# 1942408471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942408471 |
| Entity Type | Individual |
| Full Name | KEVIN JOHN BOLAK |
| Credential | C.P. |
| Practice Address |
3324 Glade St Muskegon MI 49444-2708 |
| Mailing Address |
1946 Horton Rd Muskegon MI 49445-1112 |
| Practice Telephone | 2312151419 |
| Mailing Telephone | 2312151419 |
| Mailing Fax Number | 2317447120 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | CP002002 | DE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM PROVIDER PIN | 0F10293 | 01 |
| Street Address |
3324 GLADE ST |
| City | MUSKEGON |
| State | MI |
| Zip Code | 49444-2708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285695502 | Mmsi LLC | Durable Medical Equipment & Medical Supplies | 3324 Glade St, Muskegon, MI 49444 | 2006-03-28 |
| 1922342310 | Laura Jean Allen | Orthotist | 3324 Glade St, Muskegon, MI 49444-2708 | 2012-11-26 |
| 1184895617 | Bolak and Associates Inc | Prosthetic/Orthotic Supplier | 3324 Glade St, Muskegon, MI 49444-2708 | 2008-03-12 |
| 1952520520 | Mark M Joyce | Orthotist | 3324 Glade St, Muskegon, MI 49444-2708 | 2007-04-24 |
| 1821130808 | John Robert Yarranton | Orthotist | 3324 Glade St, Muskegon, MI 49444 | 2007-02-13 |
| 1689713844 | West Michigan Pedorthics Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3324 Glade St, Muskegon, MI 49444-2708 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073084349 | Cathy Forrest, Ma, LLP Plc | Psychologist | 255 Seminole Road, Suite-205, Muskegon, MI 49444 | 2018-12-16 |
| 1831687276 | Sarah J Weiden | Massage Therapist | 1040 E Sternberg Rd, Muskegon, MI 49444 | 2018-04-30 |
| 1184131500 | Hatem M Gelani Sr. | Dentist | 1725 E Sherman Blvd, Muskegon, MI 49444 | 2018-01-08 |
| 1497123673 | Rite Aid | Pharmacist | 2213 E Hile Road, Muskegon, MI 49444 | 2015-09-04 |
| 1689077075 | Rosa Carpenter-parker | Counselor | 445 East Sherman, Muskegon, MI 49444 | 2014-09-30 |
| 1417373036 | Smile Center Pllc | Dentist | 3500 Park Street, Smile Center Pllc, Muskegon, MI 49444 | 2014-03-06 |
| 1134460439 | Adam L Powell | Physical Medicine & Rehabilitation | 1675 E Mount Garfield Rd, Muskegon, MI 49444 | 2013-03-12 |
| 1972847135 | Kristen Haugh | Physical Therapist | 5251 Harvey St Ste 100, Norton Shores, MI 49444 | 2012-11-12 |
| 1912261694 | Brandon D Freel | Obstetrics & Gynecology | 6401 Prairie St Ste 2100, Norton Shores, MI 49444 | 2012-06-27 |
| 1437434487 | Amy Stegall | Pharmacist | 1171 E Sherman, Norton Shores, MI 49444 | 2011-10-20 |
| Find all providers in zip 49444 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699385740 | Jodie Lynn Robertson | Prosthetist | 3720 Eastern Se, Grand Rapids, MI 49508 | 2020-08-04 |
| 1447877212 | Kewanna Lenise Hill | Prosthetist | 20533 Poinciana, Redford, MI 48240-1201 | 2020-06-28 |
| 1003443334 | Denitia Lynnice Morris | Prosthetist | 21537 Kelly Rd, Eastpointe, MI 48021-3213 | 2020-03-25 |
| 1245872118 | Kyra Canada | Prosthetist | 27491 Bell Rd, Southfield, MI 48034-2080 | 2019-10-11 |
| 1356902449 | Mary Free Bed Orthotics and Prosthetics | Prosthetist | 7123 Stadium Dr, Kalamazoo, MI 49009-4943 | 2019-06-28 |
| 1871958439 | Kainnon Vilminot | Prosthetist | 3469 E Grand River Ave, Suite 110, Howell, MI 48843-8504 | 2015-12-28 |
| 1629441258 | Joshua Ryder | Prosthetist | 4915 Stanton Blvd, Montague, MI 49437-1039 | 2015-11-04 |
| 1841531175 | Lindsay Muntick | Prosthetist | 5005 Cascade Rd Se, Grand Rapids, MI 49546-8411 | 2013-03-12 |
| 1588953426 | Angela Carthan-fox | Prosthetist | 1028 Professional Dr Ste A5, Flint, MI 48532-3635 | 2011-03-31 |
| 1821306911 | Paul R Cauley | Prosthetist | 6438 Woodward Ave, Detroit, MI 48202-3216 | 2010-09-22 |
| 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.