NPIMap

Organization Active NPI

Calvin University

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1609147339
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CALVIN UNIVERSITY
Practice address
3195 Knight Way SE
Grand Rapids, MI 49546-4406
Phone
(616) 526-6187
Fax
(616) 469-1398
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Authorized official

Name
Dr. Laura Deann Champion, M.D.NPI 1558314765
Title
Director
Phone
(616) 526-6678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133V00000X
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

3195 Knight Way SE
Grand Rapids, MI 49546-4406

Mailing address

3195 Knight Way SE
Grand Rapids, MI 49546-4409
Phone (616) 526-6187

Other identifiers 1

IdentifierTypeStateIssuer
1558314765OtherMINPI

Other names 1

  • Calvin Health Services Doing business as

National Provider Directory

National Provider Directory

Locations

3195 Knight Way SE
#160
Grand Rapids, MI 49546

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1609147339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3195 KNIGHT WAY SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495464409",
            "telephone_number": "616-526-6187",
            "fax_number": "616-526-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 KNIGHT WAY SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495464406",
            "telephone_number": "616-526-6187",
            "fax_number": "616-469-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVIN UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "CHAMPION",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "DEANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "616-526-6678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1558314765",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calvin Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 27, 2023; 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.