Michael Balk

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704286703 Issued in MI

Practice address

38 Commerce Ave SW Ste 102
Grand Rapids, MI 49503-4252

Phone

(616) 350-9123

Fax

(877) 599-8202

NPI assigned

Jul 8, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michael Balk Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1013535970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 COMMERCE AVE SW STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034252",
            "telephone_number": "616-350-9123",
            "fax_number": "877-599-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 COMMERCE AVE SW STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034252",
            "telephone_number": "616-350-9123",
            "fax_number": "877-599-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALK",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-08",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704286703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "26-2838743",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "BALK",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Patricia Ann Baldwin, M.S., LPC
• Meagan Balenda
• Corinna Lee Balentine, FNP-C
• Alexander Michael Balinski, MD
• Giedrius Baliulis
• Balke Counseling and Consulting LLC
• Benjamin James Balke, M.A.
• Selma S Balkic, LMSW
• Mary Kathleen Balkon, LMSW
• Elizabeth Ball

• Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.