Individual provider Active NPI

Erica R. Rose, M.D.

  • Family Medicine Physician
  • Newaygo, MI
National Provider Identifier
1679525414
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
078083 Issued in MI
Practice address
211 W Pine Lake Dr
Newaygo, MI 49337-8029
Phone
(231) 652-1631
Fax
(231) 652-1733
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 078083 MI Primary

Addresses

Primary practice location

211 W Pine Lake Dr
Newaygo, MI 49337-8029

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address erose4820@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 MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000816 MI Practitioner - Family Practice 6507834512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

211 W Pine Lake Dr
Corewell Health Gerber Hospital
Newaygo, MI 49337-8029
Phone (231) 652-1631

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
078083MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newaygo County General Hospital Association CurrentSince Apr 5, 2015 Accepting new patients
Newaygo County General Hospital Association CurrentSince Apr 5, 2015 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Mar 1, 2014 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Mar 1, 2014 Accepting new patients
Newaygo County General Hospital Association Past Accepting new patients

Locations

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

230 W Oak St
Fremont, MI 49412
Phone (231) 924-1305

230 W Oak St
Ste 201
Fremont, MI 49412
Phone (231) 924-4200

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

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

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

211 W Pine Lake Dr
Newaygo, MI 49337
Phone (231) 652-1631

Interoperability endpoints

  • Direct secure messaging: erose4820@epic00.corewelldirect.org

Organizations & group practices 5

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 3

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1679525414",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W PINE LAKE DR",
            "city": "NEWAYGO",
            "state": "MI",
            "postal_code": "493378029",
            "telephone_number": "231-652-1631",
            "fax_number": "231-652-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ERICA",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "078083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erose4820@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "211 W Pine Lake Dr",
            "city": "Newaygo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493378029",
            "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": "211 W Pine Lake Dr",
            "city": "Newaygo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493378029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newaygo, MI

Sources for this page

Verify at the official NPI Registry.