Individual provider Active NPI

Christopher R Shoemaker, MD

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1184911836
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301098590 Issued in MI
Practice address
2060 Division Ave S
Grand Rapids, MI 49507
Phone
(616) 475-8446
Fax
(616) 475-1272
NPI assigned
Jul 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301098590 MI Primary

Addresses

Primary practice location

2060 Division Ave S
Grand Rapids, MI 49507

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140605002053 MI Practitioner - Family Practice 5698919553 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exalta HealthGroup PAC ID 4789936741, 3 clinicians

Practice addresses (Care Compare)

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

2060 Division Ave S
Grand Rapids, MI 49507-3029
Phone (616) 475-8446

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301098590MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Exalta Health CurrentSince Jul 22, 2018 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Aug 1, 2016 Accepting new patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Aug 1, 2016 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

2060 Division Ave S
Grand Rapids, MI 49507
Phone (616) 475-0182

Interoperability endpoints

  • Direct secure messaging: cshoemaker26153@direct.trinity-health.org
  • Direct secure messaging: christopher.shoemaker.1@8492.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8589/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1184911836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 DIVISION AVE S",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49507",
            "telephone_number": "616-475-8446",
            "fax_number": "616-475-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301098590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.