Individual provider Active NPI

Nicole Lynn Block, MSN, NP-C

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1700488582
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704311764 Issued in MI
Practice address
2750 E Beltline Ave NE FL 3
Grand Rapids, MI 49525-8614
Phone
(616) 267-7104
NPI assigned
Nov 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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 4704311764 MI Primary

Addresses

Primary practice location

2750 E Beltline Ave NE FL 3
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
I20210406000698 MI Practitioner - Nurse Practitioner 8022425289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

2750 E Beltline Ave NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-8614
Phone (616) 267-8950

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

2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone (616) 267-8860

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jun 1, 2021 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jun 1, 2021 Accepting new patients

Locations

2750 E Beltline Ave NE
Fl 3
Grand Rapids, MI 49525
Phone (616) 447-5820

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

840 Cook Rd
Hastings, MI 49058
Phone (269) 945-4966

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

Interoperability endpoints

  • Direct secure messaging: nblock177178@epic00.corewelldirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1700488582",
    "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 FL 3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495258614",
            "telephone_number": "616-267-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704311764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.