NPIMap

Organization Active NPI

Spectrum Health Primary Care Partners

  • Advanced Practice Midwife
  • Grand Rapids, MI
National Provider Identifier
1023259249
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704173499 Issued in MI
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Practice address
4444 Kalamazoo Ave SE
Suite 104
Grand Rapids, MI 49508-4600
Phone
(616) 391-3302
NPI assigned
Mar 18, 2009
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Authorized official

Name
James Tucci
Title
President
Phone
(616) 391-2062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X 4704173499 MI Primary

Addresses

Primary practice location

4444 Kalamazoo Ave SE
Suite 104
Grand Rapids, MI 49508-4600

Mailing address

PO Box 2864
Grand Rapids, MI 49501-2864

Other identifiers 1

IdentifierTypeStateIssuer
420D121610OtherMIBCBS GROUP 420D121610

Other names 1

  • SPECTRUM HEALTH MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health Partners197 organizations share this tax ID, including this one
Part of
Spectrum Health Partners

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1023259249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2864",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495012864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 KALAMAZOO AVE SE",
            "address_2": "SUITE 104",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495084600",
            "telephone_number": "616-391-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH HOSPITAL",
        "enumeration_date": "2009-03-18",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "TUCCI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-391-2062"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704173499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP 420D121610",
            "identifier": "420D121610",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPECTRUM HEALTH MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.