NPIMap

Organization Active NPI

Spectrum Health Hospitals

  • Ambulatory Surgical Clinic/Center
  • Grand Rapids, MI
National Provider Identifier
1407313802
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SPECTRUM HEALTH HOSPITALS
Practice address
4069 Lake Dr SE Ste 210
Grand Rapids, MI 49546-8816
Phone
(616) 285-1120
NPI assigned
Feb 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Authorized official

Name
Elisabeth Lacey
Title
Manager, Enrollment Services
Phone
(616) 486-6630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

4069 Lake Dr SE Ste 210
Grand Rapids, MI 49546-8816

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other practice location 1

80 68th St SE
Grand Rapids, MI 49548-6980
Phone (616) 391-8260

Other identifiers 2

IdentifierTypeStateIssuer
1030000022OtherMISTATE OF MI
1030000014OtherMISTATE OF MI

National Provider Directory

National Provider Directory
Tax ID family
Grand Rapids Pediatrics86 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": "1550793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550793600000",
    "number": "1407313802",
    "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": "4069 LAKE DR SE STE 210",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468816",
            "telephone_number": "616-285-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 68th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495486980",
            "country_code": "US",
            "telephone_number": "616-391-8260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A",
        "authorized_official_last_name": "LACEY",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_title_or_position": "MANAGER, ENROLLMENT SERVICES",
        "authorized_official_telephone_number": "616-486-6630"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MI",
            "identifier": "1030000022",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MI",
            "identifier": "1030000014",
            "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 Feb 22, 2019; 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.