NPIMap

Organization Active NPI

Spectrum Health Primary Care Partners

Doing business as Corewell Health Medical Group West

  • Internal Medicine Physician
  • Muskegon, MI
National Provider Identifier
1366102287
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Doing business as
Corewell Health Medical Group West
Practice address
2558 Henry St
Muskegon, MI 49441-3024
Phone
(231) 291-8150
Fax
(231) 291-8155
NPI assigned
Dec 20, 2021
Last updated
Oct 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Leslie Flake
Title
VP, Finance
Phone
(616) 391-2525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

2558 Henry St
Muskegon, MI 49441-3024

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other names 1

  • Corewell Health Medical Group West Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health Partners199 organizations share this tax ID, including this one

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": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1366102287",
    "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",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2558 HENRY ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413024",
            "telephone_number": "231-291-8150",
            "fax_number": "231-291-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "FLAKE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "VP, FINANCE",
        "authorized_official_telephone_number": "616-391-2525"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Medical Group West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.