Individual provider Active NPI

Bernice Alice Theule, NP-C

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1679135958
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704194529 Issued in MI
Practice address
2750 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone
(616) 267-7015
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704194529 MI Primary

Addresses

Primary practice location

2750 E Beltline Ave NE
Grand Rapids, MI 49525-8614

Mailing address

100 Michigan St NE # Mc845
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
I20190813002361 MI Practitioner - Nurse Practitioner 9931436953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

111 S Hamilton St
Marshall, MI 49068-1537

200 N Madison St
Dept Central Billing Office
Marshall, MI 49068-1143

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ella E M Brown Charitable Circle CurrentSince Sep 9, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 1, 2022 Accepting new patients
Ella E M Brown Charitable Circle CurrentSince Sep 9, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 1, 2022 Accepting new patients

Locations

2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015

426 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7888

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

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

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

111 S Hamilton St
Marshall, MI 49068
Phone (269) 679-8120

Interoperability endpoints

  • Direct secure messaging: btheule135053@epic00.corewelldirect.org

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.

Hospital & facility affiliations 2

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1679135958",
    "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": "2750 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495258614",
            "telephone_number": "616-267-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEULE",
        "first_name": "BERNICE",
        "middle_name": "ALICE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704194529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.