Active NPI
Plastic Surgery Associates PC
- Plastic Surgery Physician
- Grand Rapids, MI
National Provider Identifier
1093899767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- Legal business name
- PLASTIC SURGERY ASSOCIATES PC
- Practice address
- 220 Lyon St NW
Suite 700
Grand Rapids, MI 49503-2208 - Phone
- (616) 451-4500
- Fax
- (616) 451-9077
- NPI assigned
- Oct 25, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Deborah Houghton-Redding
- Title
- Manager
- Phone
- (616) 451-4500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | NU | Primary |
Addresses
Primary practice location
220 Lyon St NW
Suite 700
Grand Rapids, MI 49503-2208
Mailing address
220 Lyon St NW
Suite 700
Grand Rapids, MI 49503-2208
Phone (616) 451-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Plastic Surgery Associates PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ambulatory Surgical Clinic/Center
- Grand Rapids, MI
- NPI 1548332976
Locations
220 Lyon St NW
Ste 700
Grand Rapids, MI 49503
Phone (616) 451-4500
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Plastic Surgery Physician
- Grand Rapids, MI
- NPI 1982609095
-
- Plastic Surgery Physician
- Grand Rapids, MI
- NPI 1487967733
-
- Plastic Surgery Physician
- Grand Rapids, MI
- NPI 1235133653
-
- Plastic Surgery Physician
- Grand Rapids, MI
- NPI 1487659827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1093899767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 LYON ST NW",
"address_2": "SUITE 700",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032208",
"telephone_number": "616-451-4500",
"fax_number": "616-451-9077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 LYON ST NW",
"address_2": "SUITE 700",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032208",
"telephone_number": "616-451-4500",
"fax_number": "616-451-9077"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLASTIC SURGERY ASSOCIATES PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-25",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "HOUGHTON-REDDING",
"authorized_official_first_name": "DEBORAH",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "616-451-4500",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.