Carol L. Deweerd, M.D.
Individual provider Active NPI Family Medicine Physician · Fremont, MI
NPI 1285685461 · NPPES record last updated Mar 2, 2021
Key facts
- NPI
- 1285685461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 072125 (MI)
- Practice address
- 230 W Oak St
Suite 201
Fremont, MI 49412-1575 - Phone
- (231) 924-4200
- Fax
- (231) 924-4064
- NPI assigned
- May 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Human Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Newaygo County General Hospital Association
Practice addresses (Care Compare)
204 W Main St
Corewell Health Gerber Hospital
Fremont, MI 49412-1181
Phone (231) 924-1800
212 S Sullivan Ave
Fremont, MI 49412-1548
230 W Oak St
Corewell Health Gerber Hospital
Fremont, MI 49412-1526
Phone (231) 924-4200
Hospital & facility affiliations
- Corewell Health Visiting Nurse Association
- Corewell Health Gerber Hospital
- Spectrum Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100925000237 | MI | Practitioner - Family Practice | 4880710938 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 072125 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current |
Accepting new patients | |
| Newaygo County General Hospital Association | Current |
Accepting new patients | |
| Newaygo County General Hospital Association | Current |
Accepting new patients | |
| Spectrum Health Primary Care Partners | Current |
Accepting new patients |
Locations
212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212
204 W Main St
Fremont, MI 49412
Phone (231) 924-1122
230 W Oak St
Ste 201
Fremont, MI 49412
Phone (231) 924-4200
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
211 W Pine Lake Dr
Newaygo, MI 49337
Phone (231) 652-1631
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 072125 | MI | Yes |
Addresses
Primary practice location
230 W Oak St
Suite 201
Fremont, MI 49412-1575
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | cdeweerd1757@epic00.shdirect.org |
Other providers in Fremont, MI
- Robert M Davidson
- Nicholas Decouto
- Sarah E Degen
- Claire Marie J Derks
- Jennifer M Deur
- Michael J. Deweerd
- Dialysis Care Center Fremont LLC
- Autumn Elizabeth Dittenber
- Deborah A Doneff
- Arthur Craig Drenth
All providers in Fremont, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.