Grand River Medical Associates, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5101016530 Issued in MI

Legal business name

GRAND RIVER MEDICAL ASSOCIATES, PLLC

Practice address

55840 Grand River Ave.
Suite 300
New Hudson, MI 48165

Phone

(248) 264-6169

Fax

(248) 264-6208

NPI assigned

Oct 7, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jamie Taweel, D.O.NPI 1386775419

Title

Owner, Physician

Phone

(248) 264-6169

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9525/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie George Taweel, D.O.

  • Internal Medicine Physician
  • New Hudson, MI
  • NPI 1386775419
  Medicare reassignment NPD Authorized official
• Megan Shelby Lennox, FNP-C

  • Family Nurse Practitioner
  • Ferndale, MI
  • NPI 1134883986
  Medicare reassignment NPD

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1679976526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55840 GRAND RIVER AVE.",
            "address_2": "SUITE 300",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "48165",
            "telephone_number": "248-264-6169",
            "fax_number": "248-264-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55840 GRAND RIVER AVE.",
            "address_2": "SUITE 300",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "48165",
            "telephone_number": "248-264-6169",
            "fax_number": "248-264-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RIVER MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "TAWEEL",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER, PHYSICIAN",
        "authorized_official_telephone_number": "248-264-6169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101016530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kailey Evasic, PA
• Kristin Lee Frederick, MSW
• Devon Gilbert
• Grace OT LLC
• Kathleen Grace, MS OTR
• Anish Gupta, DDS
• Healthshine Solutions Inc
• Healthy Urgent Care PLLC
• Healthy Urgent Care, PLLC
• Douglas Jay Henger

• Internal Medicine Physician in New Hudson, MI
• Providers in New Hudson, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.