DR. TIMOTHY D HENNE (NPI# 1730125428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730125428 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY D HENNE |
| Credential | M.D. |
| Practice Address |
350 Lafayette Ave Se 5th Floor Grand Rapids MI 49503-4656 |
| Mailing Address |
3565 Momentum Pl Chicago IL 60689-5335 |
| Practice Telephone | 6164599404 |
| Practice Fax Number | 6162331108 |
| Mailing Telephone | 6164599404 |
| Mailing Fax Number | 6162331108 |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2017-02-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
4301072748 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4630898 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215962709 | Timothy James Henne | Podiatrist | 3150 Citrus Tower Blvd, Suite B, Clermont, FL 34711-6802 | 2006-07-12 |
| Street Address |
350 LAFAYETTE AVE SE 5TH FLOOR |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-4656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760481782 | Geoffrey A Sandman | Orthopaedic Surgery | 350 Lafayette Ave Se, 4th Floor, Grand Rapids, MI 49503-4656 | 2005-07-20 |
| 1497205140 | Lauren Elizabeth Tweedy | Occupational Therapist | 350 Lafayette Ave Se, Grand Rapids, MI 49503-4656 | 2016-10-06 |
| 1275903163 | Jennifer Herrick | Specialist/Technologist | 350 Lafayette Ave Se, Grand Rapids, MI 49503-4656 | 2015-10-05 |
| 1134514490 | Kevin Vandokkumburg | Physician Assistant | 350 Lafayette Ave Se, 4th Floor, Grand Rapids, MI 49503-4656 | 2015-04-03 |
| 1982098356 | Amber Wilson | Specialist/Technologist | 350 Lafayette Ave Se, Grand Rapids, MI 49503-4656 | 2015-03-24 |
| 1356730048 | Gretchen Shay Goodman | Specialist/Technologist | 350 Lafayette Ave Se, Grand Rapids, MI 49503-4656 | 2015-01-18 |
| 1417380544 | Clayton J Jewell | Occupational Therapist | 350 Lafayette Ave Se, Grand Rapids, MI 49503-4656 | 2013-08-13 |
| 1437402542 | Mary Free Bed Hospital and Rehabiliation Center | Physical Therapist | 350 Lafayette Ave Se, Grand Rapids, MI 49503-4656 | 2012-10-26 |
| 1689927873 | Clarence J Verbrugge | Physical Therapist | 350 Lafayette Ave Se, Grand Rapids, MI 49503-4656 | 2012-10-25 |
| 1083972244 | Laura Miersen | Physical Therapist | 350 Lafayette Ave Se, Suite 500, Grand Rapids, MI 49503-4656 | 2012-04-25 |
| 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 | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215075106 | Carl Henry Wierks | Orthopaedic Surgery | 1000 E Paris Ave Se Ste 215, Grand Rapids, MI 49546-3680 | 2007-02-02 |
| 1003909524 | Mfb Professional Services Inc | Orthopaedic Surgery | 1155 E. Paris, Ste 200, Grand Rapids, MI 49546 | 2006-10-02 |
| 1245331941 | James R Lebolt | Orthopaedic Surgery | 4100 Lake Dr Se, Ste 300, Grand Rapids, MI 49546-8292 | 2006-09-26 |
| 1578509303 | John H Healey Jr. | Orthopaedic Surgery | 350 Lafayette Ave Se, Fourth Floor, Grand Rapids, MI 49503-4656 | 2006-06-21 |
| 1932174109 | Michigan Orthopaedics and Sports Medicine, PC | Orthopaedic Surgery | 2911 Knapp St Ne, Suite A, Grand Rapids, MI 49525 | 2006-02-21 |
| 1720076219 | Peter C Theut | Orthopaedic Surgery | 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406 | 2005-10-10 |
| 1700873874 | Thomas M Matelic | Orthopaedic Surgery | 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406 | 2005-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821472861 | Oakland University | Orthopaedic Surgery | 201 Athletics Ctr, Rochester, MI 48309 | 2015-07-18 |
| 1689871576 | Stacy Ann Frye | Orthopaedic Surgery | 3960 Patient Care Dr Ste 113, Lansing, MI 48911-4279 | 2007-07-02 |
| 1598878266 | Abdallah Simaika | Orthopaedic Surgery | 2797 Applegate Rd, Po Box 55, Applegate, MI 48401-9752 | 2006-08-16 |
| 1689662405 | Richard M Howell | Orthopaedic Surgery | 370 N 120th Ave, Holland, MI 49424-2196 | 2005-10-06 |
| 1235121138 | Steven T Plomaritis | Orthopaedic Surgery | 28001 Schoenherr Rd, Suite 3, Warren, MI 48088-4396 | 2005-08-17 |
| 1457961716 | Justin Michael Schupbach | Orthopaedic Surgery | 24 Frank Lloyd Wright Dr Lbby A, Ann Arbor, MI 48105-9484 | 2020-08-03 |
| 1053945923 | Pure Performance Orthopedics & Sports Medicine | Orthopaedic Surgery | 27207 Lahser Rd Ste 108, Southfield, MI 48034-2168 | 2020-02-28 |
| 1396377131 | Msu Health Care Inc. | Orthopaedic Surgery | 4660 S Hagadorn Rd Ste 420, East Lansing, MI 48823-5353 | 2020-02-10 |
| 1477011591 | Shannon Elizabeth Manno | Orthopaedic Surgery | 26850 Providence Pkwy Ste 260, Novi, MI 48374-1256 | 2019-03-07 |
| 1659895993 | Alexander S Russell | Orthopaedic Surgery | 2799 W Grand Blvd, Detroit, MI 48202 | 2017-07-28 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
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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.