NPIMap

Organization Active NPI

Pennant Physician Services

  • Pediatric Cardiology Physician
  • Grand Rapids, MI
National Provider Identifier
1245572007
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
PENNANT PHYSICIAN SERVICES
Practice address
555 Midtowne St NE
Suite 310
Grand Rapids, MI 49503-5729
Phone
(616) 252-4765
NPI assigned
Mar 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Authorized official

Name
Frank E Belsito, DO
Title
Cmo
Phone
(616) 252-5211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

555 Midtowne St NE
Suite 310
Grand Rapids, MI 49503-5729

Mailing address

2122 Health Dr SW
Suite 230
Wyoming, MI 49519-9698

National Provider Directory

National Provider Directory

Locations

555 Midtowne St NE
Ste 310
Grand Rapids, MI 49503
Phone (616) 252-3630

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1245572007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 HEALTH DR SW",
            "address_2": "SUITE 230",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE",
            "address_2": "SUITE 310",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035729",
            "telephone_number": "616-252-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNANT PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "BELSITO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "616-252-5211",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "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 Mar 20, 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.