Joanne Marie Grzeszak DO PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

JOANNE MARIE GRZESZAK DO PC

Practice address

806 Alger St SE
Grand Rapids, MI 49507-3803

Phone

(616) 452-8923

NPI assigned

Mar 7, 2008

Organization subpart

No

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

Authorized official

Name

Joanne M Grzeszak, DO

Title

Provider

Phone

(616) 452-8923

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1619147493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 LEONARD ST NW",
            "address_2": "SUITE 103",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495348447",
            "telephone_number": "616-453-6329",
            "fax_number": "616-453-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 ALGER ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495073803",
            "telephone_number": "616-452-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNE MARIE GRZESZAK DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "GRZESZAK",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "616-452-8923",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "00714",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2812013",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "54100135",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0154100134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brad A Johanson, DPT

• General Practice Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.