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12TH STREET INTERNAL MEDICINE AND PEDIATRICS
NPI 1790470409
Internal Medicine in Wayland, MI

Active since April 07, 2023CLIA 23D2283672 · Waiver
3587 12TH ST, WAYLAND, MI 49348(616) 648-4933 Get Directions Write a Review

NPPES record last updated: August 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 15, 2023, Aug 10, 2023, Apr 7, 2023 (3 updates tracked since 2023).

About 12th Street Internal Medicine And Pediatrics NPPES

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

12TH STREET INTERNAL MEDICINE AND PEDIATRICS (NPI 1790470409) is a healthcare organization registered as an internal medicine in Wayland, Michigan and active in the NPI registry since April 2023. The organization holds a CLIA Waiver certificate valid through June 11, 2027 and lists Joel Veldhouse, Physician Owner, as its authorized official.

NPPES Registry Identity

NPI1790470409
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business Name12TH STREET PLLC
Location Address3587 12TH STWayland, MI 49348-9569
Mailing Address3587 12th StWayland, MI 49348-9569
Phone(616) 648-4933
Organization SubpartNo
Authorized OfficialJoel VeldhousePhysician Owner · (616) 648-4933
Enumeration DateApril 7, 2023
Last NPPES UpdateAugust 15, 20233 updates tracked since enumeration
NPPES CertifiedAugust 15, 2023
✔ NPI 1790470409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPediatricsTaxonomy 208000000X
3587 12TH ST, Wayland, MI 49348
Open in Google Maps ↗

Other Names 1

Doing Business As12th Street Internal Medicine And Pediatrics

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.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 of Waiver 23D2283672

12th Street Internal Medicine And Pediatrics · Wayland, MI
Active · expires Jun 11, 2027
CLIA Number23D2283672
Laboratory TypePhysician Office
Certificate Effective DateJune 12, 2025
Certificate Expiration DateJune 11, 2027
Laboratory DirectorJoel P. Veldhouse
Laboratory Phone(269) 792-2263
Laboratory Location12th Street Internal Medicine And Pediatrics3587 12th Street, Wayland, MI 49348
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

DR. GARY BYRON GULISH D.O.
Family Medicine
3587 12TH ST
WAYLAND, MI 49348
Allegan County (269) 792-2263
JOEL PATRICK VELDHOUSE M.D.
Internal Medicine
3587 12TH ST
WAYLAND, MI 49348
Allegan County (616) 648-4933

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 12th Street PLLC's NPI number?

The NPI number for 12th Street PLLC is 1790470409. It was assigned to this organization in the NPPES registry on April 7, 2023. The provider is doing business as 12th Street Internal Medicine And Pediatrics.

Where is 12th Street PLLC located?

12th Street PLLC is located at 3587 12th St, Wayland, MI 49348. The listed phone number is (616) 648-4933.

What is 12th Street PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does 12th Street PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2283672) is associated with this NPI, valid through June 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does 12th Street PLLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list 12th Street PLLC 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 12th Street PLLC was last updated on August 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.