NPIMap

Organization Active NPI

Spectrum Health Primary Care Partners

  • Durable Medical Equipment & Medical Supplies
  • Grand Rapids, MI
National Provider Identifier
1285944322
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Practice address
4069 Lake Dr SE
Suite 314
Grand Rapids, MI 49546-8816
Phone
(616) 284-8870
NPI assigned
Oct 7, 2010
Last updated
Oct 7, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH PRIMARY CARE PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Authorized official

Name
Pauline Krywanski
Title
Cfo
Phone
(616) 486-2253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

4069 Lake Dr SE
Suite 314
Grand Rapids, MI 49546-8816

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

National Provider Directory

National Provider Directory
Part of
BMMC Ferguson Clinic

Locations

4069 Lake Dr SE
Ste 314
Grand Rapids, MI 49546
Phone (616) 267-8422

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1285944322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4069 LAKE DR SE",
            "address_2": "SUITE 314",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468816",
            "telephone_number": "616-284-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "enumeration_date": "2010-10-07",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "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 Oct 7, 2010; 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.