Individual provider Active NPI

Cheri Ann Weisner, PA

  • Physician Assistant
  • Holland, MI
National Provider Identifier
1093800443
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002925 Issued in MI
Practice address
588 E Lakewood Blvd
Holland, MI 49424-2023
Phone
(616) 494-5900
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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 5601002925 MI Primary

Addresses

Primary practice location

588 E Lakewood Blvd
Holland, MI 49424-2023

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
Direct Messaging Address cweisner24797@epic00.shdirect.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050110000861 MI Practitioner - Physician Assistant 9537117155 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

588 E Lakewood Blvd FL
Holland, MI 49424-2023

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jan 23, 2023 Accepting new patients
Bronson South Haven Hospital CurrentSince Aug 1, 2013 Accepting new patients
Spectrum Health Hospitals CurrentSince Jul 1, 2005 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 23, 2023 Accepting new patients
Bronson South Haven Hospital CurrentSince Aug 1, 2013 Accepting new patients
West Michigan Cardiology, PC CurrentSince Dec 1, 2004 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

705 S Greenville West Dr
Greenville, MI 48838
Phone (616) 325-1224

588 E Lakewood Blvd
Holland, MI 49424
Phone (616) 494-5800

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

955 S Bailey Ave
South Haven, MI 49090
Phone (269) 637-5271

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

Interoperability endpoints

  • Direct secure messaging: cweisner24797@epic00.corewelldirect.org
  • Direct secure messaging: cweisner2080539@direct.trinity-health.org

Organizations & group practices 8

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 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1093800443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 E LAKEWOOD BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242023",
            "telephone_number": "616-494-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISNER",
        "first_name": "CHERI",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "588 E Lakewood Blvd",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494242023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cweisner24797@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "588 E Lakewood Blvd",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494242023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.