Kory Allen Eastway, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704284756 Issued in MI

Practice address

3290 N Wellness Dr Ste 220
Holland, MI 49424-7261

Phone

(616) 685-7450

Fax

(616) 685-7455

NPI assigned

Jul 24, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Advantage Health/Saint Mary'S Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment Care Compare group NPD
• Advantage Health Saint Mary'S Medical Group

  dba Trinity Health Medical Group Orthopedics Grand Rapids

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary'S Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD (past)

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

• Saint Mary'S Health Services

  dba Mercy Health Saint Mary's

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  Care Compare affiliation

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1326691791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 N WELLNESS DR STE 220",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494247261",
            "telephone_number": "616-685-7450",
            "fax_number": "616-685-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N WELLNESS DR STE 220",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494247261",
            "telephone_number": "616-685-7450",
            "fax_number": "616-685-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTWAY",
        "first_name": "KORY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-24",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704284756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "keastway1027224@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mercy Health Holland Direct email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3290 N Wellness Dr Ste 220",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494247261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Claudia Dykstra
• Maria Louise Dykstra, LPC
• Russell Lee Dykstra, M.D.
• Jennifer Lynn Dys, DPT
• Drew E Graber, MA, LLPC
• Joel Benjamin David Ebbers, LLMSW
• Jessica Ann Eberly, MS, LPC
• Maureen Mika Eberly
• Lynn Edgington
• Ralph E Edgington, ACSW, LMSW

• Family Nurse Practitioner in Holland, MI
• Providers in Holland, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.