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EDWIN T KORNOELJE D.O. NPI 1023071727


NPI Information

NPI: 1023071727
Provider Name: EDWIN T KORNOELJE, D.O.
Classification: Family Medicine - 207QS0010X
Entity Type: Individual

Specialization: Sports Medicine

Organization: METROPOLITAN HOSPITAL

PECOS Registration: Yes

Address:
4300 CASCADE RD SE
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 252-1500
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Edwin T Kornoelje, D.O. is a sports medicine family medicine in Grand Rapids, MI with 29 years of experience. The provider is a family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Edwin T Kornoelje, D.O. NPI is 1023071727. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:1995

The provider's business location address is:

4300 CASCADE RD SE
GRAND RAPIDS, MI
ZIP 49546-328
Phone: (616) 252-1500
Fax: (616) 252-1599

The NPI 1023071727 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/11/2006 and was last updated on 12/5/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine5101012620MICHIGANNo
2207QS0010XFamily MedicineSports Medicine5101012620MICHIGANYes
32081S0010XPhysical Medicine & RehabilitationSports Medicine5101012620MICHIGANNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.