Individual provider Active NPI

Renee Teresa Sirois, NP

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1659740678
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704203090 Issued in MI
Practice address
743 E Beltline Ave NE
Grand Rapids, MI 49525-6045
Phone
(616) 320-0096
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704203090 MI Primary
Family Nurse Practitioner 363LF0000X 4704203090 MI

Addresses

Primary practice location

743 E Beltline Ave NE
Grand Rapids, MI 49525-6045

Mailing address

743 E Beltline Ave NE
Grand Rapids, MI 49525-6045
Phone (616) 320-0096

Other names 1

  • Renee Damstra Former name

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
I20150928000025 MI Practitioner - Nurse Practitioner 4486962339 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704203090MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Oct 1, 2015 Accepting new patients
Advantage Health Saint Mary'S Medical Group Nurse Practitioner CurrentSince Oct 1, 2015 Accepting new patients
Dr Fred PLLC CurrentSince May 26, 2024 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

743 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 456-9553

2100 Raybrook St SE
Ste 100B
Grand Rapids, MI 49546
Phone 6163200096 ext. 00096

1471 E Beltline Ave NE
Ste 201
Grand Rapids, MI 49525
Phone (616) 685-8620

1471 E Beltline Ave NE
Ste 101
Grand Rapids, MI 49525
Phone (616) 284-3180

1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500

Interoperability endpoints

  • Direct secure messaging: renee.sirois@799501387825156.direct.elationemr.com

Organizations & group practices 4

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": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1659740678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256045",
            "telephone_number": "616-320-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256045",
            "telephone_number": "616-320-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROIS",
        "first_name": "RENEE",
        "middle_name": "TERESA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704203090",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704203090",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "DAMSTRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.