NPIMap

Organization Active NPI

Spectrum Health Kelsey

Doing business as Specturm Health Kelsey Hospital

  • Hospitalist Physician
  • Lakeview, MI
National Provider Identifier
1144534520
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
1060000147 Issued in MI
Legal business name
SPECTRUM HEALTH KELSEY
Doing business as
Specturm Health Kelsey Hospital
Practice address
418 Washington St
Lakeview, MI 48850-9806
Phone
(989) 352-6474
Fax
(989) 352-8451
NPI assigned
Jul 28, 2010
Last updated
Jul 6, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH KELSEYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Authorized official

Name
Ryan Johnson
Title
Controller
Phone
(616) 225-6310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 1060000147 MI Primary

Addresses

Primary practice location

418 Washington St
Lakeview, MI 48850-9806

Mailing address

PO Box 3567
Grand Rapids, MI 49501-3567
Phone (231) 832-8555

Other names 1

  • Specturm Health Kelsey Hospital Doing business as

National Provider Directory

National Provider Directory
Part of
Kelsey Memorial Hospita

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1144534520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3567",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495013567",
            "telephone_number": "231-832-8555",
            "fax_number": "231-832-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 WASHINGTON ST",
            "city": "LAKEVIEW",
            "state": "MI",
            "postal_code": "488509806",
            "telephone_number": "989-352-6474",
            "fax_number": "989-352-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH KELSEY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH KELSEY",
        "enumeration_date": "2010-07-28",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "616-225-6310"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "1060000147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specturm Health Kelsey Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeview, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.