Organization Active NPI

Spectrum Health Hospitals

  • Pediatric Hematology & Oncology Physician
  • Traverse City, MI
National Provider Identifier
1306208244
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
Legal business name
SPECTRUM HEALTH HOSPITALS
Practice address
217 S Madison
Traverse City, MI 49684
Phone
(616) 267-1925
NPI assigned
Mar 21, 2016
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Authorized official

Name
Pauline Krywanski
Title
SVP Finance
Phone
(616) 486-2253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0207X Primary

Addresses

Primary practice location

217 S Madison
Traverse City, MI 49684

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Grand Rapids Pediatrics86 organizations share this tax ID, including this one
Part of
Grand Rapids Pediatrics

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1306208244",
    "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": "217 S MADISON",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "616-267-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH HOSPITALS",
        "enumeration_date": "2016-03-21",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "SVP FINANCE",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.