Individual provider Active NPI

Nicole Ray Dear, CNP

  • Acute Care Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1497586481
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704240154 Issued in MI
Practice address
1900 Wealthy St SE Ste 300
Grand Rapids, MI 49506-2969
Phone
(616) 774-8345
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704240154 MI Primary

Addresses

Primary practice location

1900 Wealthy St SE Ste 300
Grand Rapids, MI 49506-2969

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ndear178484@epic00.corewelldirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240927002890 MI Practitioner - Nurse Practitioner 5294266474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

1900 Wealthy St SE
Grand Rapids, MI 49506-2969

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704240154MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Nov 3, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Nov 3, 2024 Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

1900 Wealthy St SE
Ste 300
Grand Rapids, MI 49506
Phone (616) 774-2400

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1497586481",
    "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 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062969",
            "telephone_number": "616-774-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAR",
        "first_name": "NICOLE",
        "middle_name": "RAY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704240154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndear178484@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "1900 Wealthy St SE Ste 300",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495062969",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1900 Wealthy St SE Ste 300",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495062969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.