NPIMap

Organization Active NPI

Memorial Medical Center of West Michigan

  • Nurse Practitioner
  • Pentwater, MI
National Provider Identifier
1033518634
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
Practice address
500 N Hancock St
Pentwater, MI 49449-8935
Phone
(231) 869-7051
NPI assigned
Aug 19, 2014
Last updated
Aug 21, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL MEDICAL CENTER OF WEST MICHIGANAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Authorized official

Name
Mark Vipperman
Title
President
Phone
(231) 845-2297

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

500 N Hancock St
Pentwater, MI 49449-8935

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health20 organizations share this tax ID, including this one
Part of
Spectrum Health

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1033518634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N HANCOCK ST",
            "city": "PENTWATER",
            "state": "MI",
            "postal_code": "494498935",
            "telephone_number": "231-869-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MEDICAL CENTER OF WEST MICHIGAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL MEDICAL CENTER OF WEST MICHIGAN",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "VIPPERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-845-2297"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pentwater, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.