Organization Active NPI

Trueline Health Clinic PLLC

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1174389605
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRUELINE HEALTH CLINIC PLLC
Practice address
2040 Raybrook St SE Ste 200
Grand Rapids, MI 49546-7718
Phone
(616) 386-4260
NPI assigned
Feb 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Nancy Tuohy
Title
Chief Administrator
Phone
(616) 648-0095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2040 Raybrook St SE Ste 200
Grand Rapids, MI 49546-7718

Mailing address

6757 Cascade Rd SE
PMB 89
Grand Rapids, MI 49546-6849
Phone (616) 648-0095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251013001454 MI Part B Supplier - Clinic/Group Practice 3173010378 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Rapids, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2337920Trueline Health Clinic, PLLC2040 Raybrook Street SE Suite 200, Grand Rapids, MI 49546Provider-performed microscopyFeb 1, 2028

National Provider Directory

National Provider Directory

Locations

2040 Raybrook St SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 386-4260

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1174389605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6757 CASCADE RD SE",
            "address_2": "PMB 89",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466849",
            "telephone_number": "616-648-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 RAYBROOK ST SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467718",
            "telephone_number": "616-386-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUELINE HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-22",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "TUOHY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATOR",
        "authorized_official_telephone_number": "616-648-0095"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.