NPIMap

Organization Active NPI

Cascade Pediatrics LLP

  • Pediatrics Physician
  • Grand Rapids, MI
National Provider Identifier
1174639298
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CASCADE PEDIATRICS LLP
Practice address
5150 Cascade Rd SE
Suite B
Grand Rapids, MI 49546-3794
Phone
(616) 940-3168
Fax
(616) 940-3352
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Lisa Brown, MDNPI 1427164540
Title
Partner
Phone
(616) 940-3168

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

5150 Cascade Rd SE
Suite B
Grand Rapids, MI 49546-3794

Mailing address

5150 Cascade Rd SE
Suite B
Grand Rapids, MI 49546-3794
Phone (616) 940-3168

Other identifiers 1

IdentifierTypeStateIssuer
350D16208OtherMIBCBS MICHIGAN

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
23D0893493Cascade Pediatrics LLP5150 Cascade Road SE Suite B, Grand Rapids, MI 49546Certificate of waiverMar 2, 2027

National Provider Directory

National Provider Directory

Locations

5150 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 940-3168

5150 Cascade Rd SE
Ste B
Grand Rapids, MI 49546
Phone (616) 940-3168

Practitioners & affiliated clinicians

Practitioners 12

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": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1174639298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 CASCADE RD SE",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463794",
            "telephone_number": "616-940-3168",
            "fax_number": "616-940-3352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 CASCADE RD SE",
            "address_2": "SUITE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463794",
            "telephone_number": "616-940-3168",
            "fax_number": "616-940-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE PEDIATRICS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "616-940-3168",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MICHIGAN",
            "identifier": "350D16208",
            "state": "MI"
        }
    ],
    "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 Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.