NPIMap

Organization Active NPI

Spectrum Health Primary Care Partners

Doing business as Corewell Health Medical Group West

  • Pediatrics Physician
  • Holland, MI
National Provider Identifier
1144539313
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Doing business as
Corewell Health Medical Group West
Practice address
442 Century LN
Holland, MI 49423-4294
Phone
(616) 396-3942
NPI assigned
Oct 5, 2010
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH PRIMARY CARE PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Pauline Krywanski
Title
Cfo
Phone
(616) 486-2253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

442 Century LN
Holland, MI 49423-4294

Mailing address

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

Other names 1

  • Corewell Health Medical Group West Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum HLTH Care Partners199 organizations share this tax ID, including this one
Part of
Spectrum HLTH Care Partners

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

442 Century Ln
Holland, MI 49423
Phone (616) 396-3429

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1144539313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 CENTURY LN",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234294",
            "telephone_number": "616-396-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "enumeration_date": "2010-10-05",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Medical Group West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.