Michael James Madura, M.D,

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301043486 Issued in MI

Practice address

1900 Wealthy St SE
Ste 150
Grand Rapids, MI 49506-2969

Phone

(616) 459-3158

Fax

(616) 459-4714

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: michaelmadura@gvmsplc.allscriptsdirect.net

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1497862437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WEALTHY ST SE",
            "address_2": "STE 150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062969",
            "telephone_number": "616-459-3158",
            "fax_number": "616-459-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WEALTHY ST SE",
            "address_2": "STE 150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062969",
            "telephone_number": "616-459-3158",
            "fax_number": "616-459-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADURA",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301043486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "1004100351",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3318794",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS TAX ID# THRU CORP",
            "identifier": "38-2145264",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn L Madry, LPC, M.S.
• Hannah R Madsen
• Rachel Madsen, DPT
• Abigail Madura
• Casey J Madura, M.D.
• Jody Maertz
• Nancy Martina Magallon, L.P.N.
• Victor Magana Castro, MD
• Michael Joseph Maggio, PHYSICIAN ASSISTANT
• Magic Touch Salon

• Gastroenterology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.