NPIMap

Organization Active NPI

Spectrum Health United

  • Social Worker
  • Vestaburg, MI
National Provider Identifier
1336765445
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
SPECTRUM HEALTH UNITED
Practice address
7188 Avenue B
Vestaburg, MI 48891-9502
Phone
(616) 754-6185
NPI assigned
Jun 24, 2020
Last updated
Jun 24, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH UNITEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Authorized official

Name
Elisabeth Lacey
Title
Credentialing MGR
Phone
(616) 486-6630

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Social Worker 104100000X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

7188 Avenue B
Vestaburg, MI 48891-9502

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

National Provider Directory

National Provider Directory
Tax ID family
United Mem Hospital40 organizations share this tax ID, including this one
Part of
United Mem Hospital

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1336765445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7188 AVENUE B",
            "city": "VESTABURG",
            "state": "MI",
            "postal_code": "488919502",
            "telephone_number": "616-754-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH UNITED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH UNITED",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "LACEY",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_title_or_position": "CREDENTIALING MGR",
        "authorized_official_telephone_number": "616-486-6630"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestaburg, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.