Individual provider Active NPI

Holly White, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1205292802
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2750 E Beltline Ave NE FL 1
Grand Rapids, MI 49525
Phone
(616) 447-5850
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2750 E Beltline Ave NE FL 1
Grand Rapids, MI 49525

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/
Direct Messaging Address hwhite119639@epic00.shdirect.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160212000792 MI Practitioner - Physician Assistant 7517261449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
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)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

2750 E Beltline Ave NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-8614
Phone (616) 267-8950

2750 E Beltline Ave NE FL
Grand Rapids, MI 49525-8614

2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone (616) 267-8860

3800 Lake Michigan Dr NW a
Corewell Health Medical Group West
Grand Rapids, MI 49534-4583
Phone (616) 453-8225

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Apr 11, 2016 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Apr 11, 2016 Accepting new patients

Locations

2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

3800 Lake Michigan Dr NW
Ste A
Grand Rapids, MI 49534
Phone (616) 267-8225

2750 E Beltline Ave NE
Fl 1
Grand Rapids, MI 49525
Phone (616) 391-6271

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: hwhite119639@epic00.shdirect.org
  • Direct secure messaging: hwhite119639@epic00.corewelldirect.org

Organizations & group practices 3

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 2

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": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1205292802",
    "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",
            "telephone_number": "616-486-6790",
            "fax_number": "616-486-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 E BELTLINE AVE NE FL 1",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-447-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "HOLLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2750 E Beltline Ave NE Fl 1",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hwhite119639@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "2750 E Beltline Ave NE Fl 1",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.