Individual provider Active NPI

Andrew J Head, M.D.

  • Rheumatology Physician
  • Grand Rapids, MI
National Provider Identifier
1235323072
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301083216 Issued in MI
Practice address
1155 E Paris Ave SE
Ste 100
Grand Rapids, MI 49546-8368
Phone
(616) 459-8088
Fax
(616) 459-8312
NPI assigned
Sep 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 4301083216 MI Primary

Addresses

Primary practice location

1155 E Paris Ave SE
Ste 100
Grand Rapids, MI 49546-8368

Mailing address

1155 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546-8368
Phone (616) 459-8088

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address andrew.head@wmr.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040817001241 MI Practitioner - Rheumatology 6002889078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301083216MIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Chester Hospital LLC Past Accepting new patients
University of Cincinnati Medical Center, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1235323072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 EAST PARIS AVE SE",
            "address_2": "STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468368",
            "telephone_number": "616-459-8088",
            "fax_number": "616-459-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 E PARIS AVE SE",
            "address_2": "STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468368",
            "telephone_number": "616-459-8088",
            "fax_number": "616-459-8312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301083216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrew.head@wmr.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "West Michigan Rheumatology Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "eCW",
            "address_1": "1155 E Paris Ave SE",
            "address_2": "Ste 100",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468368",
            "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.