NPIMap

Organization Active NPI

Spectrum Health Hospital

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1497329726
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SPECTRUM HEALTH HOSPITAL
Practice address
1900 Wealthy St SE Ste 200
Grand Rapids, MI 49506-2969
Phone
(616) 774-0276
NPI assigned
May 20, 2021
Last updated
May 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Elisabeth Lacey
Title
Credentialing Manager
Phone
(616) 486-6630

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1900 Wealthy St SE Ste 200
Grand Rapids, MI 49506-2969

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health87 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": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1497329726",
    "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": "1900 WEALTHY ST SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062969",
            "telephone_number": "616-774-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "LACEY",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "616-486-6630"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "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 May 20, 2021; 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.