Active NPI
Sarah Rosanne Skavnak, NP
- Pediatric Nurse Practitioner
- Grand Rapids, MI
National Provider Identifier
1548585367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 4704229858
- Practice address
- 100 Michigan St NE # Mc117
Grand Rapids, MI 49503-2560 - Phone
- (616) 267-0118
- NPI assigned
- Apr 5, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704229858 | MI | |
| Pediatric Nurse Practitioner | 363LP0200X | 4704229858 | MI | Primary |
Addresses
Primary practice location
100 Michigan St NE # Mc117
Grand Rapids, MI 49503-2560
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sskavnak118742@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704229858 | MI | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennock Hospital | Nurse Practitioner | Past | Accepting new patients |
Interoperability endpoints
- sskavnak118742@epic00.corewelldirect.org
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1548585367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE # MC117",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-267-0118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKAVNAK",
"first_name": "SARAH",
"middle_name": "ROSANNE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-05",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704229858",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MI",
"license": "4704229858",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sskavnak118742@epic00.shdirect.org",
"affiliation": "N",
"address_1": "100 Michigan St NE # Mc117",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032560",
"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": "100 Michigan St NE # Mc117",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032560",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.