Individual provider Active NPI

Natasha D Dehaan, NP

  • Acute Care Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1295051209
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704245179 Issued in MI
Practice address
4069 Lake Dr SE Ste 118
Grand Rapids, MI 49546-8816
Phone
(616) 267-8520
Fax
(616) 363-0724
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704245179 MI Primary

Addresses

Primary practice location

4069 Lake Dr SE Ste 118
Grand Rapids, MI 49546-8816

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ndehaan10528@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100526000898 MI Practitioner - Nurse Practitioner 3375672579 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Health HospitalsGroup PAC ID 8921904764, 161 clinicians
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

100 Michigan St Northeast
Corewell Health Grand Rapids Hospit
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

145 Michigan St NE
4100 Corewell Health Medical Group West
Grand Rapids, MI 49503-2567
Phone (616) 486-6314

15100 Whittaker Way
Grand Haven, MI 49417-8696
Phone (616) 772-4644

3800 Lake Michigan Dr NW a
Corewell Health Medical Group West
Grand Rapids, MI 49534-4583
Phone (616) 453-8225

4069 Lake Dr SE
Grand Rapids, MI 49546-8816

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704245179MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2011 Accepting new patients
Spectrum Health Hospitals CurrentSince Sep 25, 2017 Accepting new patients
Spectrum Health Hospitals CurrentSince Sep 25, 2017 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2011 Accepting new patients
Michigan Medical Patient Care Past Accepting new patients
Michigan Medical Patient Care Past Accepting new patients

Locations

4829 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 363-9069

4085 Burton St SE
Ste 200
Grand Rapids, MI 49546

100 Michigan St NE
#20
Grand Rapids, MI 49503
Phone (616) 391-1751

4069 Lake Dr SE
Ste 118
Grand Rapids, MI 49546
Phone (616) 267-8520

3800 Lake Michigan Dr NW
Ste A
Grand Rapids, MI 49534
Phone (616) 267-8225

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: ndehaan10528@epic00.corewelldirect.org
  • Direct secure messaging: ndehaan10528@epic00.shdirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1295051209",
    "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 STE 118",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468816",
            "telephone_number": "616-267-8520",
            "fax_number": "616-363-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAAN",
        "first_name": "NATASHA",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704245179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndehaan10528@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "4069 Lake Dr SE Ste 118",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4069 Lake Dr SE Ste 118",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495468816",
            "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.