Krista Tisdel, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087231 Issued in MI

Practice address

25 Conran Dr Ste B
Coopersville, MI 49404-1366

Phone

(616) 267-7860

NPI assigned

Jun 30, 2014

Last updated

Dec 4, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Family Medicine Physician
  • Coopersville, MI
  • NPI 1346510229
  NPD (past)

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1346655255",
    "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": "25 CONRAN DR STE B",
            "city": "COOPERSVILLE",
            "state": "MI",
            "postal_code": "494041366",
            "telephone_number": "616-267-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDEL",
        "first_name": "KRISTA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Susan Steenstra, DC
• Marcia Joy Stonehouse, LMSW
• Morgan Jean Sundblad Hsieh, MD
• Kimberly Tew, PA
• Cheryl Ann Thomas, LPN
• Uplift Therapies, LLC
• Kara Lynne Vanderboon, OTR/L
• Nicole Marie Vandussen, LMSW
• Christina Marie Vanhouten, LMSW
• Melissa Vankampen, PTA

• Clinical Social Worker in Coopersville, MI
• Providers in Coopersville, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.