Rachel Kloosterman

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704288163 Issued in MI

Practice address

615 S Bower St
Greenville, MI 48838-2614

Phone

(616) 486-6790

Fax

(616) 486-6702

NPI assigned

Jul 14, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rachel Tissue Former name

Electronic endpoints 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Michigan State University College of Human Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkloosterman89201@epic00.shdirect.org
• Direct secure messaging: rkloosterman89201@epic00.corewelldirect.org

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.

• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment Care Compare group NPD
• Spectrum Health United

  • General Acute Care Hospital
  • Greenville, MI
  • NPI 1457304495
  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• Spectrum Health Primary Care Partners

  • Hospitalist Physician
  • Grand Rapids, MI
  • NPI 1790093763
  NPD
• Spectrum Health United

  • Family Medicine Physician
  • Greenville, MI
  • NPI 1063781342
  NPD

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

• Spectrum Health United

  • General Acute Care Hospital
  • Greenville, MI
  • NPI 1457304495
  Care Compare affiliation

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1194178129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MAIL CODE 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S BOWER ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382614",
            "telephone_number": "616-486-6790",
            "fax_number": "616-486-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOOSTERMAN",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-14",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704288163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkloosterman89201@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "615 S Bower St",
            "city": "Greenville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488382614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "615 S Bower St",
            "city": "Greenville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488382614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "TISSUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin T Oconnor DO PC
• Kimberlee J Odonald PT PC
• Kimberly B Lavender, LLC
• Jenny E Kipp, DNP
• Tammy Kay Kirby, ARNP-C
• Catherine Anne Knisley, RPH
• Sara Lyn Koenes, PA-C
• Elizabeth R Koerner, PA-C
• Suzanne Kaye Komdeur, LMSW
• Bobbye June Koning, M.D.

• Nurse Practitioner in Greenville, MI
• Providers in Greenville, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.