NPIMap

Organization Active NPI

Spectrum Health United

  • Registered Dietitian
  • Greenville, MI
National Provider Identifier
1417385170
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SPECTRUM HEALTH UNITED
Practice address
701 S Greenville West Dr
Ste. 1
Greenville, MI 48838-3516
Phone
(616) 754-6185
NPI assigned
Oct 16, 2013
Last updated
Oct 16, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH UNITEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Authorized official

Name
Pauline Krywanski
Title
SVP Finance
Phone
(616) 486-2253

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X NU
Registered Dietitian 133V00000X NU Primary

Addresses

Primary practice location

701 S Greenville West Dr
Ste. 1
Greenville, MI 48838-3516

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

National Provider Directory

National Provider Directory
Tax ID family
United Mem Hosp Emerg P40 organizations share this tax ID, including this one
Part of
United Mem Hosp Emerg P

Other organizations with this tax ID 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1417385170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S GREENVILLE WEST DR",
            "address_2": "STE. 1",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488383516",
            "telephone_number": "616-754-6185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH UNITED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH UNITED",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "SVP FINANCE",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.