Marc Godfrey Schlatter, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

4301048761 Issued in MI

Practice address

330 Barclay Ave NE
Suite202
Grand Rapids, MI 49503-2556

Phone

(616) 458-1722

Fax

(616) 458-0061

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mschlatter4994@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.

• Pediatric Surgeons of West Michigan PC

  • Surgery Physician
  • Grand Rapids, MI
  • NPI 1477516110
  Medicare reassignment NPD
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235288317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BARCLAY AVE NE",
            "address_2": "SUITE202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032556",
            "telephone_number": "616-458-1722",
            "fax_number": "616-458-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BARCLAY AVE NE",
            "address_2": "SUITE202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032556",
            "telephone_number": "616-458-1722",
            "fax_number": "616-458-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLATTER",
        "first_name": "MARC",
        "middle_name": "GODFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MI",
            "license": "4301048761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2973767",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Schipper, PA-C
• Colette Marie Schippers, LMHC
• Tenille Schlachter
• Megan Schlaefflin
• Stephen Michael Schlaefflin
• Liesel Scout Schlorke, PHARMD
• Devin Schlossberg, DO
• Julianna Kay Schloz, PNP
• Kelli Schlueter, PHARMD
• Danielle D Schmachtenberger, PA

• Pediatric Surgery Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.