Active NPI
James M. Wynalda, M.D.
- Pediatrics Physician
- Grand Rapids, MI
National Provider Identifier
1427027861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301053498
- Practice address
- 840 Brookville Plaza SE
Grand Rapids, MI 49508 - Phone
- (616) 243-5707
- Fax
- (616) 243-1170
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301053498 | MI | Primary |
Addresses
Primary practice location
840 Brookville Plaza SE
Grand Rapids, MI 49508
Mailing address
8485 Algoma Ave
P.O.Box 346
Rockford, MI 49341
Phone (616) 863-6220
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11292441 | Other | MI | CAQH |
| 4737974 | Medicaid | MI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1427027861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8485 ALGOMA AVE",
"address_2": "P.O.BOX 346",
"city": "ROCKFORD",
"state": "MI",
"postal_code": "49341",
"telephone_number": "616-863-6220",
"fax_number": "616-863-6221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 BROOKVILLE PLAZA SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49508",
"telephone_number": "616-243-5707",
"fax_number": "616-243-1170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYNALDA",
"first_name": "JAMES",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301053498",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11292441",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4737974",
"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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.