Individual provider Active NPI

Carl Wierks, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Grand Rapids, MI
National Provider Identifier
1215075106
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
4301096643 Issued in MI
Practice address
2144 E Paris Ave SE Ste 240
Grand Rapids, MI 49546-6117
Phone
(616) 949-8945
Fax
(616) 949-1115
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 4301096643 MI Primary

Addresses

Primary practice location

2144 E Paris Ave SE Ste 240
Grand Rapids, MI 49546-6117

Mailing address

2144 E Paris Ave SE Ste 240
Grand Rapids, MI 49546-6117
Phone (616) 949-8945

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
I20110127000155 MI Practitioner - Orthopedic Surgery 9032398722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western Michigan Bone and Joint Surgeons PCGroup PAC ID 8224128194, 5 clinicians
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

2144 E Paris Ave SE
Suite 240
Grand Rapids, MI 49546-6117
Phone (616) 949-8945

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement19

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Western Michigan Bone & Joint Surgeons PC Sports Medicine CurrentSince May 18, 2015 Accepting new patients
West Michigan Surgical Center, LLC Past Accepting new patients

Locations

2144 East Paris Ave SE
Ste 240
Grand Rapids, MI 49546
Phone (616) 949-8945

1000 East Paris Ave SE
Ste 215
Grand Rapids, MI 49546
Phone (616) 279-3725

8300 Logistics Dr
Zeeland, MI 49464
Phone (616) 748-0630

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1215075106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 E PARIS AVE SE STE 240",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466117",
            "telephone_number": "616-949-8945",
            "fax_number": "616-949-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2144 E PARIS AVE SE STE 240",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466117",
            "telephone_number": "616-949-8945",
            "fax_number": "616-949-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERKS",
        "first_name": "CARL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MI",
            "license": "4301096643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.