Individual provider Active NPI

Cynthia Ann Betterly, DNP

  • Gerontology Nurse Practitioner
  • Byron Center, MI
National Provider Identifier
1508254426
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704278798 Issued in MI
Practice address
7751 Byron Center Ave SW Ste C
Byron Center, MI 49315-8001
Phone
(616) 267-7668
NPI assigned
Dec 30, 2014
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704278798 MI Primary

Addresses

Primary practice location

7751 Byron Center Ave SW Ste C
Byron Center, MI 49315-8001

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cbetterly9959@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
I20150225002450 MI Practitioner - Nurse Practitioner 2163748781 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704278798MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group Nurse Practitioner CurrentSince Oct 15, 2015 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Oct 15, 2015 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Dec 7, 2020 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Dec 7, 2020 Accepting new patients

Locations

7751 Byron Center Ave SW
Ste C
Byron Center, MI 49315
Phone (616) 267-0357

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

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

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500

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

Interoperability endpoints

  • Direct secure messaging: cbetterly9959@epic00.corewelldirect.org

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1508254426",
    "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": "7751 BYRON CENTER AVE SW STE C",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158001",
            "telephone_number": "616-267-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTERLY",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-30",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704278798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbetterly9959@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "7751 Byron Center Ave SW Ste C",
            "city": "Byron Center",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493158001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "7751 Byron Center Ave SW Ste C",
            "city": "Byron Center",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493158001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

Verify at the official NPI Registry.