Individual provider Active NPI

Heather Dickinson, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1144269291
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004153 Issued in MI
Practice address
4300 Cascade Rd SE
Grand Rapids, MI 49546-8328
Phone
(616) 252-1500
Fax
(616) 252-1599
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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 5601004153 MI Primary

Addresses

Primary practice location

4300 Cascade Rd SE
Grand Rapids, MI 49546-8328

Mailing address

5900 Byron Center Ave SW
Medical Administration
Wyoming, MI 49519-9606
Phone (616) 252-3243

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
I20040716000363 MI Practitioner - Physician Assistant 1052390796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

1310 E Beltline Ave SE
Metro Health Beltline
Grand Rapids, MI 49506-4300
Phone (616) 252-1500

2215 44TH St SW
Wyoming, MI 49519-6439

5900 Byron Ctr Ave
Wyoming, MI 49519-9606

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-3243

5900 Byron Ctr Swave
Wyoming, MI 49519-9606
Phone (616) 252-7200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004153MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Jun 1, 2016 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

4200 Division Ave N
Comstock Park, MI 49321
Phone (616) 252-1600

4300 Cascade Rd SE
Ste 100
Grand Rapids, MI 49546

1310 E Beltline Ave SE
Grand Rapids, MI 49506
Phone (616) 252-1500

4300 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-1500

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

2215 44th St SW
Ste 100
Wyoming, MI 49519
Phone (616) 252-8300

Interoperability endpoints

  • Direct secure messaging: hdickinson584@direct.metrohealth.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 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1144269291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243",
            "fax_number": "616-252-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468328",
            "telephone_number": "616-252-1500",
            "fax_number": "616-252-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "HEATHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.