NPIMap

Organization Active NPI

Physician'S Home Network, PLLC

  • Adult Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1386971711
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
PHYSICIAN'S HOME NETWORK, PLLC
Practice address
3033 Orchard Vista Dr SE
Suite 309
Grand Rapids, MI 49546-7077
Phone
(616) 608-7403
Fax
(616) 608-7408
NPI assigned
Nov 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

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

Authorized official

Name
Kurtis Smitko, MSPT
Title
Ceo
Phone
(616) 608-7403

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

3033 Orchard Vista Dr SE
Suite 309
Grand Rapids, MI 49546-7077

Mailing address

3033 Orchard Vista Dr SE
Suite 309
Grand Rapids, MI 49546-7077
Phone (616) 608-7403

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257379200000",
    "number": "1386971711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 ORCHARD VISTA DR SE",
            "address_2": "SUITE 309",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467077",
            "telephone_number": "616-608-7403",
            "fax_number": "616-608-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 ORCHARD VISTA DR SE",
            "address_2": "SUITE 309",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467077",
            "telephone_number": "616-608-7403",
            "fax_number": "616-608-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN'S HOME NETWORK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2009-11-05",
        "status": "A",
        "authorized_official_last_name": "SMITKO",
        "authorized_official_first_name": "KURTIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-608-7403",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 5, 2009; 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.