NPIMap

Organization Active NPI

Spectrum Health Hospitals

Doing business as Corewell Health Grand Rapids Hospitals

  • Clinical Genetics (M.D.) Physician
  • Grand Rapids, MI
National Provider Identifier
1184934291
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
Legal business name
SPECTRUM HEALTH HOSPITALS
Doing business as
Corewell Health Grand Rapids Hospitals
Practice address
25 Michigan St NE
Suite 2000
Grand Rapids, MI 49503-2515
Phone
(616) 391-2700
NPI assigned
Oct 8, 2010
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207SG0201X Primary

Addresses

Primary practice location

25 Michigan St NE
Suite 2000
Grand Rapids, MI 49503-2515

Mailing address

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

Other names 1

  • Corewell Health Grand Rapids Hospitals Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health DT87 organizations share this tax ID, including this one
Part of
Spectrum Health DT

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

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1184934291",
    "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": "25 MICHIGAN ST NE",
            "address_2": "SUITE 2000",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032515",
            "telephone_number": "616-391-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH HOSPITALS",
        "enumeration_date": "2010-10-08",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "PAULINE (POLLY)",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Grand Rapids Hospitals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 2, 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.