NPIMap

Organization Active NPI

Spectrum Health Primary Care Partners

Doing business as Corewell Health Medical Group West

  • Obstetrics & Gynecology Physician
  • Grandville, MI
National Provider Identifier
1669854816
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Doing business as
Corewell Health Medical Group West
Spectrum Health Medical Group
Practice address
4249 Parkway Place Dr SW
Grandville, MI 49418-2679
Phone
(616) 774-7035
NPI assigned
Jun 24, 2015
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH PRIMARY CARE PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Pauline Krywanski
Title
SVP Finance
Phone
(616) 486-2253

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X

Addresses

Primary practice location

4249 Parkway Place Dr SW
Grandville, MI 49418-2679

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other names 2

  • Corewell Health Medical Group West Doing business as
  • Spectrum Health Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health Partners197 organizations share this tax ID, including this one
Part of
Spectrum Health Partners

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1669854816",
    "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",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4249 PARKWAY PLACE DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182679",
            "telephone_number": "616-774-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "enumeration_date": "2015-06-24",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "SVP FINANCE",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Medical Group West",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grandville, MI

Sources for this page

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