Creston Medical Center, PLLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

4301029675 Issued in MI

Legal business name

CRESTON MEDICAL CENTER, PLLC

Practice address

1330 Plainfield Ave NE
Grand Rapids, MI 49505-4913

Phone

(616) 776-1275

Fax

(616) 776-3713

NPI assigned

Jul 1, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Margo Maryland App, PHD

Title

Administrator

Phone

(616) 776-0814

Specialties & licenses 1

Addresses

Other names 1

• Creston Medical Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ruth Jean Vandenberg, P.A.-C.

  • Physician Assistant
  • Grand Rapids, MI
  • NPI 1679783120
  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1154583078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2564",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495012564",
            "telephone_number": "616-776-1275",
            "fax_number": "616-776-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 PLAINFIELD AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054913",
            "telephone_number": "616-776-1275",
            "fax_number": "616-776-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTON MEDICAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "APP",
        "authorized_official_first_name": "MARGO",
        "authorized_official_middle_name": "MARYLAND",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "616-776-0814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MI",
            "license": "4301029675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creston Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erika Crenshaw, LMSW
• Stefano Crescentini, MD
• Jessica Crespo
• Scott Cressman, M.D.
• Cresswell Counseling
• Creston Medical Service, PC
• Naomi Cret, MD
• Douglas Gary Crew, D.O.
• Samantha Jo Crider, PT
• George A Cripps, D.D.S.

• Health Service Clinic/Center in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Health Service Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.