NPIMap

Organization Active NPI

Optimed Healthcare Partners, PLLC

Doing business as OptiMed Healthcare Partners

  • General Practice Physician
  • Grand Rapids, MI
National Provider Identifier
1619658713
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OPTIMED HEALTHCARE PARTNERS, PLLC
Doing business as
OptiMed Healthcare Partners
Practice address
4021 Cascade Rd SE Ste 60
Grand Rapids, MI 49546-2177
Phone
(269) 250-8000
Fax
(269) 250-8020
NPI assigned
Jul 31, 2023
Organization subpart
Yes
Parent organization
OPTIMED HEALTHCARE PARTNERS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Andrew J Reeves, R.PH.
Title
Authorized Agent
Phone
(269) 250-8018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

4021 Cascade Rd SE Ste 60
Grand Rapids, MI 49546-2177

Mailing address

6480 Technology Ave Ste a
Kalamazoo, MI 49009-8126
Phone (269) 250-8000

Other names 1

  • OptiMed Healthcare Partners Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Optimed Healthcare Partners2 organizations share this tax ID, including this one
Part of
Optimed Healthcare Partners

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4021 Cascade Rd SE
Ste 60
Grand Rapids, MI 49546
Phone (269) 250-8000

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1619658713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 TECHNOLOGY AVE STE A",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098126",
            "telephone_number": "269-250-8000",
            "fax_number": "269-250-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 CASCADE RD SE STE 60",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462177",
            "telephone_number": "269-250-8000",
            "fax_number": "269-250-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMED HEALTHCARE PARTNERS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTIMED HEALTHCARE PARTNERS, PLLC",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "269-250-8018",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OptiMed Healthcare Partners",
            "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 31, 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.