Individual provider Active NPI

Mary M Cherrette, NP-C

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1225679491
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704279126 Issued in MI
Practice address
310 Lafayette Ave SE Ste 415
Grand Rapids, MI 49503-4693
Phone
(616) 685-5666
Fax
(616) 685-8969
NPI assigned
Sep 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704279126 MI Primary

Addresses

Primary practice location

310 Lafayette Ave SE Ste 415
Grand Rapids, MI 49503-4693

Mailing address

310 Lafayette Ave SE Ste 415
Grand Rapids, MI 49503-4693
Phone (616) 685-5666

Other practice location 1

577 Michigan Ave Ste 201
Holland, MI 49423-4911
Phone (616) 392-1816

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
I20200411000220 MI Practitioner - Nurse Practitioner 1759710817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

310 Lafayette Ave SE
Suite 415
Grand Rapids, MI 49503-4693
Phone (616) 685-5666

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary'S Medical Group Nurse Practitioner CurrentSince Feb 10, 2021 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Feb 10, 2021 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

310 Lafayette Ave SE
Ste 415
Grand Rapids, MI 49503
Phone (616) 685-5666

Interoperability endpoints

  • Direct secure messaging: mcherrette24311@direct.trinity-health.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 1

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1225679491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE STE 415",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-685-5666",
            "fax_number": "616-685-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE STE 415",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-685-5666",
            "fax_number": "616-685-8969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "577 Michigan Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494234911",
            "country_code": "US",
            "telephone_number": "616-392-1816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHERRETTE",
        "first_name": "MARY",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704279126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.