NPIMap

Individual provider Active NPI

Brittany Alexis Grosvenor, PA-C

  • Physician Assistant
  • Norton Shores, MI
National Provider Identifier
1043877848
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009187 Issued in MI
Practice address
6425 Harvey St
Norton Shores, MI 49444-9739
Phone
(231) 798-4866
Fax
(231) 798-6391
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601009187 MI Primary

Addresses

Primary practice location

6425 Harvey St
Norton Shores, MI 49444-9739

Mailing address

6425 Harvey St
Norton Shores, MI 49444-9739
Phone (231) 798-4866

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bgrosvenor148622@direct.covenanthealthcare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190722003545 MI Practitioner - Physician Assistant 4880920321 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Free Bed Rehabilitation HospitalGroup PAC ID 4587576541, 135 clinicians

Practice addresses (Care Compare)

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 242-0422

235 Wealthy St SE FL
5 Mary Free Bed Skilled Nursing
Grand Rapids, MI 49503-5247
Phone (616) 840-8162

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601009187MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince May 1, 2020 Accepting new patients
Mary Free Bed Rehabilitation Hospital CurrentSince May 15, 2023 Accepting new patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Sep 11, 2019 Accepting new patients
Sparrow Carson Hospital CurrentSince May 1, 2020 Accepting new patients
Advantage Health Saint Mary'S Medical Group Physician Assistant CurrentSince Sep 11, 2019 Accepting new patients
Mary Free Bed Rehabilitation Hospital Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

235 Wealthy St SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 493-9724

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

Interoperability endpoints

  • Direct secure messaging: bgrosvenor148622@direct.covenanthealthcare.com
  • Direct secure messaging: bgranett148745@direct.trinity-health.org

Organizations & group practices 9

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 2

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1043877848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 HARVEY ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449739",
            "telephone_number": "231-798-4866",
            "fax_number": "231-798-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 HARVEY ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449739",
            "telephone_number": "231-798-4866",
            "fax_number": "231-798-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSVENOR",
        "first_name": "BRITTANY",
        "middle_name": "ALEXIS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgrosvenor148622@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "6425 Harvey St",
            "city": "Norton Shores",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494449739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.