GENEVIEVE T BASTOS (NPI# 1902843774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902843774 |
| Entity Type | Individual |
| Full Name | GENEVIEVE T BASTOS |
| Credential | NP |
| Practice Address |
2700 E Centre Ave Portage MI 49002-5500 |
| Mailing Address |
5943 Stadium Dr Ste 3 Kalamazoo MI 49009-3016 |
| Practice Telephone | 2692867050 |
| Practice Fax Number | 2692867051 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4704216473 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8001 Angling Rd, Portage, MI 490247422 | 2693290944 |
| Street Address |
2700 E CENTRE AVE |
| City | PORTAGE |
| State | MI |
| Zip Code | 49002-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515402 | Bethany Joy Adams | Social Worker | 2700 E Centre Ave, Portage, MI 49002-5500 | 2020-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604204 | Susan Vandewalker | Physical Therapist | 8001 Angling Rd., Portage, MI 49002 | 2018-03-28 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1386045383 | Pinnacle Senior Care of Kalamazoo, LLC | Home Health | 2725 Airview Blvd Ste 105b, Portage, MI 49002 | 2014-09-09 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1619211919 | Daketia L Thomas | Massage Therapist | 8314 Portage Rd, Suite D, Kalamazoo, MI 49002 | 2012-11-27 |
| 1831457142 | Kinetic Kids, LLC | Occupational Therapist | 540 East Milham, Portage, MI 49002 | 2012-04-25 |
| 1154689404 | Lauren Michelle Mattaliano | Occupational Therapist | 540 E. Milham Road, Portage, MI 49002 | 2012-04-24 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
| Find all providers in zip 49002 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902913171 | Jeanne Leadley | Nurse Practitioner | 6560 Pleasantview Dr, Portage, MI 49024-1035 | 2006-08-24 |
| 1902886518 | Mary J Schira | Nurse Practitioner | 2680 W Centre Ave, Rambling Road Pediatrics Portage, Portage, MI 49024-4828 | 2006-01-19 |
| 1073506119 | Kathleen L Ludwikowski | Nurse Practitioner | 317 Dewitt St, Portage, WI 53901-2155 | 2005-08-24 |
| 1639177983 | Ann Patrice Sheehan | Nurse Practitioner | 670 Mall Dr, Portage, MI 49024-2878 | 2005-07-11 |
| 1679058218 | Carah Beth Lemmen | Nurse Practitioner | 2680 W Centre Ave, Portage, MI 49024-4828 | 2018-09-29 |
| 1912987595 | Nancy L Maudlin | Nurse Practitioner | 2680 W Centre Ave, Rambling Rd Pediatrics- Portage, Portage, MI 49024-4828 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851991061 | Sarah Elizabeth Barber | Nurse Practitioner | 12918 Lake Point Pass, Van Buren Twp, MI 48111-2243 | 2020-10-27 |
| 1730700881 | Kelsey Olinik | Nurse Practitioner | 22200 Barclay Dr, Novi, MI 48374-3874 | 2020-04-29 |
| 1467080705 | Jessica Nicole Heichel | Nurse Practitioner | 7729 Brass Creek Ct, Dexter, MI 48130-9384 | 2020-03-31 |
| 1114550506 | Katlyn Roberts | Nurse Practitioner | 60160 E 8 Mile Rd, South Lyon, MI 48178-9768 | 2020-02-13 |
| 1093351595 | Emily Janina Jamett | Nurse Practitioner | 31815 Southfield Rd Ste 10, Beverly Hills, MI 48025-5471 | 2019-11-20 |
| 1508410747 | Clorissa Diedrich | Nurse Practitioner | 829 N Center Ave Ste 130, Gaylord, MI 49735-1684 | 2019-07-25 |
| 1255895355 | Jessica Lynn Kata | Nurse Practitioner | 19229 Mack Ave Ste 28, Grosse Pointe Woods, MI 48236-2857 | 2019-01-23 |
| 1467934679 | Anita Lynn Riddle | Nurse Practitioner | 100 W. Vanburen Street, Battle Creek, MI 49017 | 2018-09-04 |
| 1285120634 | Alexandra Danko | Nurse Practitioner | 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 | 2018-07-09 |
| 1417442617 | Shelby Fredricks | Nurse Practitioner | 1205 S Mission St Ste 4, Mount Pleasant, MI 48858-3939 | 2018-06-29 |
| 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.