Spectrum Health Primary Care Partners
Organization Active NPI Pediatric Endocrinology Physician · Grand Rapids, MI
NPI 1326599671 · NPPES record last updated Oct 26, 2023
Key facts
- NPI
- 1326599671
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Endocrinology Physician 2080P0205X
- Legal business name
- SPECTRUM HEALTH PRIMARY CARE PARTNERS
- Practice address
- 35 Michigan St NE Ste 1800
Grand Rapids, MI 49503-2568 - Phone
- (616) 391-3933
- NPI assigned
- Oct 21, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- SPECTRUM HEALTH PRIMARY CARE PARTNERS
Authorized official
- Name
- Ryan Catignani
- Title
- VP Finance
- Phone
- (947) 522-0008
Other NPIs on the same Medicare enrollment 13
Practitioners 52
-
Tabetha Emily Bergeron, PA-C
-
Sarah Bertus, PA-C
-
Gary Bissonette, PA
-
Sarah Ruth Bremer, PA-C
-
Michael Joseph Charney, PA-C
-
Theodore A Dorsey, PA-C
-
Danielle Susan Douglass, PA-C
-
Stacy Michelle Emmert, PA-C
-
Claire Margaret Esparza, PA-C
-
Adam Farrell, PA-C
-
Lindsey Ann Ferris, PA-C
-
Anne Elisa Gordon, PA-C
-
Travis Ryan Guest, PA-C
-
John F Harris, DPM, FACFAS
-
Ross Kooienga, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031121000091 | MI | Part B Supplier - Clinic/Group Practice | 4587568647 |
Receives reassigned benefits from 3,022 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Spectrum Health Partners
Locations
230 Michigan St NE
Ste 101
Grand Rapids, MI 49503
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | |||
| Pediatric Endocrinology Physician |
2080P0205X | Yes |
Addresses
Primary practice location
35 Michigan St NE Ste 1800
Grand Rapids, MI 49503-2568
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Other names
- Corewell Health Medical Group West Pediatric Diabetes Education
- Spectrum Health Medical Group
Other providers in Grand Rapids, MI
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
All providers in Grand Rapids, MI · Pediatric Endocrinology 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 Oct 26, 2023. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.