NPIMap

Organization Active NPI

Spectrum Health Hospitals

  • Neurological Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1225339773
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
SPECTRUM HEALTH HOSPITALS
Practice address
412 Plymouth Ave NE
Grand Rapids, MI 49505-6028
Phone
(616) 742-5902
NPI assigned
Nov 15, 2010
Last updated
Nov 15, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Polly Krywanski
Title
SVP of Finance
Phone
(616) 486-2253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

412 Plymouth Ave NE
Grand Rapids, MI 49505-6028

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health87 organizations share this tax ID, including this one
Part of
Spectrum Health

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": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1225339773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-742-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM  HEALTH HOSPITALS",
        "enumeration_date": "2010-11-15",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "POLLY",
        "authorized_official_title_or_position": "SVP OF FINANCE",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 15, 2010; 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.