Individual provider Active NPI

Katie Marie Needler, NP

  • Gerontology Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1659742153
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704381179 Issued in MI
Practice address
2900 Bradford St NE
Grand Rapids, MI 49525-6427
Phone
(616) 885-5000
NPI assigned
Oct 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704381179 MI Primary

Addresses

Primary practice location

2900 Bradford St NE
Grand Rapids, MI 49525-6427

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other names 1

  • Katie Rainey Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kneedler338169@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210428000475 AR Practitioner - Nurse Practitioner 5991005209
I20220203002049 MI Practitioner - Nurse Practitioner 5991005209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

3152 Port Sheldon St
Hudsonville, MI 49426-9297
Phone (616) 494-5830

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

6105 Wilson Ave SW
Wyoming, MI 49418-9714

6105 Wilson Ave SW FL
2 Corewell Health Medical Group West
Wyoming, MI 49418-9714
Phone (616) 267-8950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704381179MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Feb 21, 2022 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Feb 21, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

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

2900 Bradford St NE
Grand Rapids, MI 49525

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

6105 Wilson Ave SW
Ste 101
Wyoming, MI 49418
Phone (616) 608-8300

Interoperability endpoints

  • Direct secure messaging: katie.needler.p1@direct.phvvmed.nextgenshare.com
  • Direct secure messaging: kneedler338169@epic00.shdirect.org
  • Direct secure messaging: kneedler338169@epic00.corewelldirect.org

Organizations & group practices 3

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.

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": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1659742153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "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": "NEEDLER",
        "first_name": "KATIE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704381179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kneedler338169@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "2900 Bradford St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495256427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2900 Bradford St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495256427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "RAINEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.