NPIMap

Organization Active NPI

Cancer & Hematology Centers of Western Mi, P.C.

  • Clinical Medical Laboratory
  • Grand Rapids, MI
National Provider Identifier
1386864080
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CANCER & HEMATOLOGY CENTERS OF WESTERN MI, P.C.
Practice address
710 Kenmoor Ave SE
Grand Rapids, MI 49546-2302
Phone
(616) 389-1800
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Authorized official

Name
Lisa Vincent
Title
Credentialing Specialist
Phone
(616) 560-3258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

710 Kenmoor Ave SE
Grand Rapids, MI 49546-2302

Mailing address

5800 Foremost Dr SE Ste 300
Grand Rapids, MI 49546-7062
Phone (616) 954-9800

Other practice location 1

12460 Riley St
Holland, MI 49424-8217
Phone (616) 399-6500

Other practice location 2

6255 Inkster Rd Ste 306
Garden City, MI 48135-2538
Phone (734) 458-3279

Other practice location 3

145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2562
Phone (616) 954-9800

Other practice location 4

15100 220th Ave
Big Rapids, MI 49307-9248
Phone (231) 515-9410

Other practice location 5

302 Kensington Ave
Flint, MI 48503-2044
Phone (810) 762-8400

Other practice location 6

18223 E 10 Mile Rd
Roseville, MI 48066-5821
Phone (586) 778-5880

Other practice location 7

6425 Harvey St
Norton Shores, MI 49444-9739
Phone (231) 737-3469

Other practice location 8

1550 Watertower Pl Ste 500
East Lansing, MI 48823-8053
Phone (517) 333-6060

Other practice location 9

5800 Foremost Dr SE Ste 100
Grand Rapids, MI 49546-7062
Phone (616) 389-1561

Other identifiers 10

IdentifierTypeStateIssuer
23D0675313OtherMICLIA
23D0973254OtherMICLIA
23D1081376OtherMICLIA
23D2235787OtherMICLIA
23D2314500OtherMICLIA
23D2125912OtherMICLIA
23D0923923OtherMICLIA
23D0929489OtherMICLIA
23D0873642OtherMICLIA
23D2277833OtherMICLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000091 MI Part B Supplier - Clinic/Group Practice 4082526793 Receives reassigned benefits from 134 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Rapids, MI; Holland, MI; Lapeer, MI; Mt Pleasant, MI; Norton Shores, MI; Roseville, MI; Saint Johns, MI; Big Rapids, MI…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0675313Cancer and Hematology Centers, the18223 E 10 Mile Road, Roseville, MI 48066ComplianceNov 4, 2027
23D0873642Cancer and Hematology Centers, the145 Michigan St NE Suite 3100, Grand Rapids, MI 49503ComplianceDec 14, 2026
23D0923923Cancer and Hematology Centers, the302 Kensington Avenue, Flint, MI 48503ComplianceJan 29, 2027
23D0929489Cancer and Hematology Centers, the12460 Riley Street, Holland, MI 49424ComplianceDec 8, 2027
23D0973254Cancer and Hematology Centers, the1550 Watertower Place Suite 500, East Lansing, MI 48823ComplianceSep 26, 2026
23D1081376Cancer and Hematology Centers, the6425 S Harvey St, Norton Shores, MI 49444ComplianceJul 2, 2028
23D2125912Cancer and Hematology Centers, the5800 Foremost Drive SE, Suite 100, Grand Rapids, MI 49546ComplianceNov 19, 2027
23D2277833Cancer and Hematology Centers, the15100 220TH Avenue, Big Rapids, MI 49307ComplianceJan 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
Cancer Hematology Centers of Western Mi PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

5800 Foremost Dr SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 954-5554

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1386864080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062",
            "telephone_number": "616-954-9800",
            "fax_number": "616-954-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 KENMOOR AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462302",
            "telephone_number": "616-389-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12460 Riley St",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494248217",
            "country_code": "US",
            "telephone_number": "616-399-6500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6255 Inkster Rd Ste 306",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "MI",
            "postal_code": "481352538",
            "country_code": "US",
            "telephone_number": "734-458-3279",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "145 Michigan St NE",
            "address_2": "Suite 3100",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032562",
            "country_code": "US",
            "telephone_number": "616-954-9800",
            "fax_number": "616-954-2116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15100 220th Ave",
            "address_purpose": "LOCATION",
            "city": "Big Rapids",
            "state": "MI",
            "postal_code": "493079248",
            "country_code": "US",
            "telephone_number": "231-515-9410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 Kensington Ave",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485032044",
            "country_code": "US",
            "telephone_number": "810-762-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18223 E 10 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MI",
            "postal_code": "480665821",
            "country_code": "US",
            "telephone_number": "586-778-5880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6425 Harvey St",
            "address_purpose": "LOCATION",
            "city": "Norton Shores",
            "state": "MI",
            "postal_code": "494449739",
            "country_code": "US",
            "telephone_number": "231-737-3469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1550 Watertower Pl Ste 500",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488238053",
            "country_code": "US",
            "telephone_number": "517-333-6060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5800 Foremost Dr SE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495467062",
            "country_code": "US",
            "telephone_number": "616-389-1561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CANCER & HEMATOLOGY CENTERS OF WESTERN MI, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "616-560-3258"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D0675313",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D0973254",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D1081376",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D2235787",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D2314500",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D2125912",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D0923923",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D0929489",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D0873642",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D2277833",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.