Grand Valley Medical Specialists PLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GRAND VALLEY MEDICAL SPECIALISTS PLC

Practice address

1000 East Paris Ave SE Ste 100
Grand Rapids, MI 49546-3680

Phone

(616) 459-3158

Fax

(616) 742-6758

NPI assigned

Aug 23, 2006

Last updated

Nov 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joanne Reynolds

Title

Credentialing Specialist

Phone

(616) 235-4800

Specialties & licenses 3

Addresses

Other names 1

• Grand Valley Internal Medicine Specialists, PLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel William Bergner, M.D.

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1538306659
  Medicare reassignment Care Compare group NPD
• Thomas V Bilisko, MD

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1275537011
  Medicare reassignment Care Compare group NPD
• Michael J Bultje, DO

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1144224882
  Medicare reassignment Care Compare group NPD
• Sharyn N Doden, DO

  • Family Medicine Physician
  • Grand Rapids, MI
  • NPI 1063154748
  Medicare reassignment Care Compare group NPD
• Emily Suzanne Haligowski, FNP

  • Family Nurse Practitioner
  • Wyoming, MI
  • NPI 1518243278
  Medicare reassignment Care Compare group NPD
• John W Hamersma, M.D.

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1033108329
  Medicare reassignment Care Compare group NPD
• Michael Kenneth Hofman

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1710541404
  Medicare reassignment Care Compare group NPD
• Joyce M Jensen, FNP

  • Family Nurse Practitioner
  • Grand Rapids, MI
  • NPI 1013024983
  Medicare reassignment Care Compare group NPD
• Jeffry D Knibbe, MD

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1700825296
  Medicare reassignment Care Compare group NPD
• Robert D. Lang, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1871597377
  Medicare reassignment Care Compare group NPD
• Bruce A Langerak, D.O.

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1467569475
  Medicare reassignment Care Compare group NPD
• Jared Langerak, M.D.

  • Family Medicine Physician
  • Grand Rapids, MI
  • NPI 1497169635
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1033226402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EAST PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463680",
            "telephone_number": "616-459-3158",
            "fax_number": "616-742-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EAST PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463680",
            "telephone_number": "616-459-3158",
            "fax_number": "616-742-6758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2093 Health Dr SW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199691",
            "country_code": "US",
            "telephone_number": "616-459-3158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRAND VALLEY MEDICAL SPECIALISTS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "616-235-4800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Valley Internal Medicine Specialists, PLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Grand Valley Internal Medicine Specialists, PLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Grand River Mobility LLC (Next Day Access of Grand Rapids and Lansing)
• Grand River Rehabilitation LLC
• Grand Valley Dental Care, P.C.
• Grand Valley Family Health Center
• Grand Valley Gynecologists, P.C.
• Grand Valley State University
• Grand Valley Surgical Center, LLC
• Grand Wellness, LLC
• Lisa J Grandon, LPN
• Andrea Marie Grandy, LPC, LLMFT

• Internal Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.