Organization Active NPI

Marywood Health Corporation

  • Skilled Nursing Facility
  • Grand Rapids, MI
National Provider Identifier
1235479767
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MARYWOOD HEALTH CORPORATION
Practice address
111 Lakeside Dr NE
Grand Rapids, MI 49503-3811
Phone
(616) 456-1993
Fax
(616) 454-6105
NPI assigned
Feb 20, 2013
Last updated
Mar 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Ms. Lisa McMichael
Title
Nursing Home Administrator
Phone
(616) 490-2942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

111 Lakeside Dr NE
Grand Rapids, MI 49503-3811

Mailing address

4450 Cascade Rd SE
Ste 200
Grand Rapids, MI 49546-8330
Phone (616) 949-4975

Other names 1

  • Marywood Health Center Former legal business name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1235479767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 CASCADE RD SE",
            "address_2": "STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468330",
            "telephone_number": "616-949-4975",
            "fax_number": "616-954-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LAKESIDE DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033811",
            "telephone_number": "616-456-1993",
            "fax_number": "616-454-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYWOOD HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "MCMICHAEL",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "NURSING HOME ADMINISTRATOR",
        "authorized_official_telephone_number": "616-490-2942",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marywood Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 27, 2013; 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.