KEAGHAN OTTENBAKER (NPI# 1558987149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558987149 |
| Entity Type | Individual |
| Full Name | KEAGHAN OTTENBAKER |
| Credential | DO |
| Practice Address |
300 Lafayette Ave Se Ste 4000 Grand Rapids MI 49503-4692 |
| Mailing Address |
200 Jefferson Ave Se Grand Rapids MI 49503-4502 |
| Practice Telephone | 6166856922 |
| Mailing Telephone | 6166856922 |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2020-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5151014380 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
300 LAFAYETTE AVE SE STE 4000 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-4692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316920614 | Michael C Bishop | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503 | 2005-11-22 |
| 1043836612 | Jacob Iceberg | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| 1679199178 | Stephany Zahl | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| 1790301356 | Nadia Bronte Churchill-gilstrap | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| 1871119362 | Carolyn Rivard | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| 1588280077 | Stephen Brooks Smith | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| 1952927444 | Peter Siegel | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| 1306462809 | Anna Sudbury | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| 1407472087 | Molly Kempa | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| 1861018442 | Bailey Ledy | Family Medicine | 300 Lafayette Ave Se Ste 4000, Grand Rapids, MI 49503-4692 | 2020-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083239974 | Mercy Health Partners | Family Medicine | 826 Parchment Dr Se Ste 210, Grand Rapids, MI 49546-2307 | 2020-06-16 |
| 1740810563 | Spectrum Health Primary Care Partners | Family Medicine | 435 Ionia Ave Sw, Grand Rapids, MI 49503-5161 | 2020-01-21 |
| 1932748050 | Alexander Corcoran Pa-c LLC | Family Medicine | 2340 College Ave Se, Grand Rapids, MI 49507-3108 | 2020-01-06 |
| 1649757071 | St. Lukes Primary Care | Family Medicine | 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 | 2018-07-27 |
| 1619463775 | Zlex, Pllc | Family Medicine | 847 Parchment Dr Se Ste 100, Grand Rapids, MI 49546-2303 | 2018-07-02 |
| 1558856518 | Leland Cary Gyr | Family Medicine | 25 Michigan St Ne Ste 5300, Grand Rapids, MI 49503-2515 | 2018-06-22 |
| 1982126355 | Jeffrey Dufresne | Family Medicine | 300 Lafayette Ave. Se, Grand Rapids, MI 49503 | 2017-07-07 |
| 1386165157 | Samantha V Mcpharlin | Family Medicine | 300 Lafayette Ave Se Ste 400, Grand Rapids, MI 49503 | 2017-07-03 |
| 1639699481 | Andrew R Izzo | Family Medicine | 3200 Eagle Park Dr Ne Ste 102, Grand Rapids, MI 49525-7057 | 2017-06-22 |
| 1871908970 | Marc Arenas | Family Medicine | 245 Cherry St Se Ste 200, Grand Rapids, MI 49503 | 2014-06-26 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on KEAGHAN OTTENBAKER.
| 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.