NPIMap

Individual provider Active NPI

Erin Megan Pettijohn, M.D.

  • Hematology & Oncology Physician
  • Grand Rapids, MI
National Provider Identifier
1003101429
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301111782 Issued in MI
Practice address
250 Cherry St SE Ste 2200
Grand Rapids, MI 49503-4608
Phone
(616) 685-5600
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 4301111782 MI Primary

Addresses

Primary practice location

250 Cherry St SE Ste 2200
Grand Rapids, MI 49503-4608

Mailing address

5800 Foremost Dr SE Ste 300
Grand Rapids, MI 49546-7062
Phone (616) 954-9800

Other names 1

  • Erin Megan Bernethy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170726000097 MI Practitioner - Hematology/Oncology 5890094510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12460 Riley St
Holland, MI 49424-8217
Phone (616) 399-6500

145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2563
Phone (616) 954-9800

5800 Foremost Dr SE
Grand Rapids, MI 49546-7062
Phone (616) 954-9800

6425 S Harvey St
Norton Shores, MI 49444-9739
Phone (231) 737-3469

710 Kenmoor Ave SE
Suite 200
Grand Rapids, MI 49546-2379
Phone (616) 389-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301111782MIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer & Hematology Centers of Western Mi, P.C. CurrentSince Aug 7, 2017 Accepting new patients
Spectrum Health Hospitals Past Accepting new patients
Spectrum Health Hospitals Internal Medicine Past Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. Past Accepting new patients

Locations

5800 Foremost Dr SE
Ste 300
Grand Rapids, MI 49546
Phone (616) 389-1725

710 Kenmoor Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 588-7246

250 Cherry St SE
Ste 2200
Grand Rapids, MI 49503
Phone (616) 685-5600

145 Michigan St NE
Ste 3100
Grand Rapids, MI 49503
Phone (616) 954-9800

1440 E Sherman Blvd
Ste 200
Muskegon, MI 49444
Phone (231) 332-5871

6425 Harvey St
Norton Shores, MI 49444
Phone (231) 737-3469

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1003101429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062",
            "telephone_number": "616-954-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHERRY ST SE STE 2200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034608",
            "telephone_number": "616-685-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIJOHN",
        "first_name": "ERIN",
        "middle_name": "MEGAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301111782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "BERNETHY",
            "middle_name": "MEGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.