Individual provider Active NPI

Robert Charles Mackinder, MD

  • Internal Medicine Physician
  • Ada, MI
National Provider Identifier
1124022660
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301063583 Issued in MI
Practice address
7128 Fulton St E
Ada, MI 49301-8413
Phone
(616) 825-3530
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301063583 MI
Internal Medicine Physician 207R00000X 4301063583 MI Primary

Addresses

Primary practice location

7128 Fulton St E
Ada, MI 49301-8413

Mailing address

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

Other practice location 1

3271 Clear Vista Ct NE
Grand Rapids, MI 49525-9477
Phone (616) 391-7800

Other identifiers 1

IdentifierTypeStateIssuer
4199731MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address robert.Mackinder@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
I20060905000545 MI Practitioner - Pediatric MedicinePractitioner - Internal Medicine 2567466543 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Michigan State University College of Human Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
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)

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

2249 Wealthy St SE
110 Corewell Health Medical Group West
East Grand Rapids, MI 49506-3055
Phone (616) 391-4600

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

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

7128 Fulton St E
Corewell Health Medical Group West
Ada, MI 49301-8413
Phone (616) 825-3559

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jun 1, 2000 Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Jun 1, 2000 Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine Current Accepting new patients
Spectrum Health Hospitals CurrentSince Jun 1, 1999 Accepting new patients
Spectrum Health Hospitals Internal Medicine CurrentSince Jun 1, 1999 Accepting new patients

Locations

7128 Fulton St E
Ada, MI 49301
Phone (616) 825-3500

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

25 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-0800

3271 Clear Vista Ct NE
Grand Rapids, MI 49525
Phone (616) 267-7125

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

2332 Alpine Ave NW
Grand Rapids, MI 49544
Phone (616) 363-3311

25 Michigan St NE
Ste 2100
Grand Rapids, MI 49503
Phone (616) 391-3777

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

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

Interoperability endpoints

  • Direct secure messaging: robert.mackinder@epic00.shdirect.org
  • Direct secure messaging: rmackinder3661@epic00.corewelldirect.org

Organizations & group practices 6

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1124022660",
    "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": "7128 FULTON ST E",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493018413",
            "telephone_number": "616-825-3530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3271 Clear Vista Ct NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495259477",
            "country_code": "US",
            "telephone_number": "616-391-7800",
            "fax_number": "616-391-7838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKINDER",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301063583",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301063583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4199731",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.Mackinder@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "3271 Clear Vista Ct NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495259477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3271 Clear Vista Ct NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495259477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ada, MI

Sources for this page

Verify at the official NPI Registry.