Active NPI
Lethecia D Hernandez, MD
- Internal Medicine Physician
- Grand Rapids, MI
National Provider Identifier
1386866770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301083856
- Practice address
- 21 Michigan NE Suite 525
Grand Rapids, MI 49503 - Phone
- (616) 391-3775
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301083856 | MI | Primary |
Addresses
Primary practice location
21 Michigan NE Suite 525
Grand Rapids, MI 49503
Mailing address
3948 North Rosebud Court SE
Kentwood, MI 49512
Phone (616) 656-3410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301083856 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Mary'S Health Services | Past | Accepting new patients | |
| Advantage Health Physicians PC | Internal Medicine | Past | Accepting new patients |
| Trinity Health - Michigan | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Grand Rapids, MI
- NPI 1386695252
Internal Medicine
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1639111057
-
- Federally Qualified Health Center (FQHC)
- Grand Rapids, MI
- NPI 1902002272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386866770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3948 NORTH ROSEBUD COURT SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "49512",
"telephone_number": "616-656-3410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 MICHIGAN NE SUITE 525",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49503",
"telephone_number": "616-391-3775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "LETHECIA",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301083856",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.