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RANDALL STREET MEDICAL PC
NPI 1598734584
Clinic/Center - Rural Health in Coopersville, MI

Active since March 14, 2006CLIA 23D0379159 · Microscopy
675 W RANDALL ST, COOPERSVILLE, MI 49404(616) 837-9777(616) 837-7813 Get Directions Write a Review

NPPES record last updated: July 22, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Randall Street Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDALL STREET MEDICAL PC (NPI 1598734584) is a healthcare organization registered as a rural health in Coopersville, Michigan and active in the NPI registry since March 2006. The organization holds a CLIA Microscopy certificate valid through March 3, 2028 and lists Roger Holman, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1598734584
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameRANDALL STREET MEDICAL PC
Location Address675 W RANDALL STCoopersville, MI 49404-1305
Mailing Address675 W Randall StCoopersville, MI 49404-1305 · (616) 837-9777 · Fax (616) 837-7813
Phone(616) 837-9777
Fax(616) 837-7813
Organization SubpartNo
Authorized OfficialRoger HolmanOwner/physician · (616) 837-9777
Enumeration DateMarch 14, 2006
Last NPPES UpdateJuly 22, 2008
✔ NPI 1598734584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in MI · 5101006733
675 W RANDALL ST, Coopersville, MI 49404
Open in Google Maps ↗

Other Identifiers 7

Other005703574MI · Bcbsmi
Medicare UPINS79627MI
OtherP57675MI · Blues Hmo's
Medicare UPINE26596MI
Medicare OSCAR/certification233956MI
Other0027003MI · Priority Health Hmo
Medicaid4313667MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 23D0379159

Randall Street Medical PC · Coopersville, MI
Active · expires Mar 3, 2028
CLIA Number23D0379159
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2026
Certificate Expiration DateMarch 3, 2028
Laboratory DirectorRoger Holman
Laboratory Phone(616) 837-9777
Laboratory LocationRandall Street Medical PC675 West Randall Street, Coopersville, MI 49404
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROGER HOLMAN DO
Family Medicine
675 W RANDALL ST
COOPERSVILLE, MI 49404
Ottawa County (616) 837-9777
LEAH BOEVE FNP
Nurse Practitioner (Family)
675 W RANDALL ST
COOPERSVILLE, MI 49404
Ottawa County (616) 889-6011
MRS. HEIDI JO PARCHER AGPCNP-BC
Family Medicine
675 W RANDALL ST
COOPERSVILLE, MI 49404
Ottawa County (616) 837-9777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randall Street Medical PC's NPI number?

The NPI number for Randall Street Medical PC is 1598734584. It was assigned to this organization in the NPPES registry on March 14, 2006.

Where is Randall Street Medical PC located?

Randall Street Medical PC is located at 675 W Randall St, Coopersville, MI 49404. The listed phone number is (616) 837-9777.

What is Randall Street Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Randall Street Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0379159) is associated with this NPI, valid through March 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Randall Street Medical PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Randall Street Medical PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Randall Street Medical PC was last updated on July 22, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.