Individual provider Active NPI

Joseph R Blodgett, M.D.

  • Pediatric Adolescent Medicine Physician
  • Holland, MI
National Provider Identifier
1699736280
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
4301056079 Issued in MI
Practice address
588 E Lakewood Blvd
1St Floor
Holland, MI 49424-2023
Phone
(616) 494-5840
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 4301056079 MI Primary

Addresses

Primary practice location

588 E Lakewood Blvd
1St Floor
Holland, MI 49424-2023

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jblodgett118504@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
I20040408000167 MI Practitioner - Pediatric Medicine 3375536899 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301056079MIMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mecosta County Medical Center CurrentSince Jan 4, 2016 Accepting new patients
Reed City Hospital Corporation Current Accepting new patients
Reed City Hospital Corporation CurrentSince Jan 4, 2016 Accepting new patients
Mecosta County Medical Center Current Accepting new patients
Mecosta County Medical Center Pediatrics CurrentSince Jan 4, 2016 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Apr 30, 2017 Accepting new patients
Spectrum Health Primary Care Partners Adolescent Medicine CurrentSince Apr 30, 2017 Accepting new patients
Reed City Hospital Corporation CurrentSince Jan 4, 2016 Accepting new patients

Locations

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

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

588 E Lakewood Blvd
Fl 1
Holland, MI 49424
Phone (616) 494-5800

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

300 N Patterson Rd
Reed City, MI 49677
Phone (231) 832-3271

Interoperability endpoints

  • Direct secure messaging: jblodgett118504@epic00.corewelldirect.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1699736280",
    "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": "588 E LAKEWOOD BLVD",
            "address_2": "1ST FLOOR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242023",
            "telephone_number": "616-494-5840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLODGETT",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301056079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jblodgett118504@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "588 E Lakewood Blvd",
            "address_2": "1st Floor",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494242023",
            "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": "588 E Lakewood Blvd",
            "address_2": "1st Floor",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494242023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.