Individual provider Active NPI

Andrew D Mepham, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1619419827
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008026 Issued in MI
Practice address
2900 Bradford St NE
Grand Rapids, MI 49525-6427
Phone
(616) 885-5000
NPI assigned
Nov 7, 2016
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008026 MI Primary

Addresses

Primary practice location

2900 Bradford St NE
Grand Rapids, MI 49525-6427

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

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
I20170126002251 MI Practitioner - Physician Assistant 2567744527 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

221 Michigan St NE
300 Corewell Health Medical Group West
Grand Rapids, MI 49503-2537
Phone (616) 459-7258

2900 Bradford St NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-6427
Phone (616) 885-5000

2902 Bradford St NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-6427
Phone (616) 486-6577

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

602 Michigan Ave
Suite 102
Holland, MI 49423-4918
Phone (616) 494-8724

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601008026MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jun 11, 2021 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jun 11, 2021 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Dec 1, 2021 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Pennock Hospital Past Accepting new patients
Spectrum Health Primary Care Partners PastSince Nov 18, 2025 Accepting new patients

Locations

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

221 Michigan St NE
Ste 300
Grand Rapids, MI 49503
Phone (616) 459-7258

2900 Bradford St NE
Grand Rapids, MI 49525

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

1009 W Green St
Hastings, MI 49058
Phone (269) 945-1212

1108 W State St
Ste 3
Hastings, MI 49058
Phone (269) 945-0922

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

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

490 Edward St
Middleville, MI 49333
Phone (269) 795-4434

1675 E Mount Garfield Rd
Muskegon, MI 49444
Phone (231) 799-8880

Interoperability endpoints

  • Direct secure messaging: amepham2668653@direct.trinity-health.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1619419827",
    "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": "2900 BRADFORD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256427",
            "telephone_number": "616-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEPHAM",
        "first_name": "ANDREW",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-07",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.