Individual provider Active NPI

David Francis Lieuwen, M.D.

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1043214414
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301098801 Issued in MI
Practice address
1000 East Paris Ave SE Ste 100
Grand Rapids, MI 49546
Phone
(616) 459-3158
Fax
(616) 742-1945
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 40601 CO
Family Medicine Physician 207Q00000X 4301098801 MI Primary

Addresses

Primary practice location

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

Mailing address

1000 East Paris Ave SE Ste 100
Grand Rapids, MI 49546-3680
Phone (616) 459-3158

Other practice location 1

2093 Health Dr SW Ste 200
Wyoming, MI 49519-9691
Phone (616) 459-3158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110818000921 MI Practitioner - Family Practice 9335130806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Valley Medical Specialists PLCGroup PAC ID 1254311947, 19 clinicians
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

1000 E Paris Ave SE
Suite 100
Grand Rapids, MI 49546-3680
Phone (616) 459-3158

5060 Cascade Rd
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

  • Mary Free Bed at Home, LLC Home health agency, Grand Rapids, MI, CCN 237203
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40601COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Valley Medical Specialists PLC Family Medicine CurrentSince Sep 6, 2011 Accepting new patients

Locations

1000 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 459-3158

1900 Wealthy St SE
Ste 150
Grand Rapids, MI 49506
Phone (616) 459-3158

2093 Health Dr SW
Ste 200
Wyoming, MI 49519
Phone (616) 459-3158

Interoperability endpoints

  • Direct secure messaging: davidlieuwen@gvmsplc.allscriptsdirect.net

Organizations & group practices 2

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 5

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1043214414",
    "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": "616-742-1945"
        },
        {
            "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": "49546",
            "telephone_number": "616-459-3158",
            "fax_number": "616-742-1945"
        }
    ],
    "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": {
        "last_name": "LIEUWEN",
        "first_name": "DAVID",
        "middle_name": "FRANCIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "40601",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301098801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.