Individual provider Active NPI

Jeffry D Knibbe, MD

  • Internal Medicine Physician
  • Wyoming, MI
National Provider Identifier
1700825296
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301074143 Issued in MI
Practice address
2093 Health Dr SW Ste 200
Wyoming, MI 49519-9691
Phone
(616) 459-3158
Fax
(616) 819-2222
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301074143 MI Primary

Addresses

Primary practice location

2093 Health Dr SW Ste 200
Wyoming, MI 49519-9691

Mailing address

2093 Health Dr SW Ste 200
Wyoming, MI 49519-9691
Phone (616) 459-3158

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
I20090713000462 MI Practitioner - Internal Medicine 6901958529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Human Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Valley Medical Specialists PLCGroup PAC ID 1254311947, 19 clinicians
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

2093 Health Dr SW
Suite 200
Wyoming, MI 49519-9691
Phone (616) 988-0737

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

  • Mary Free Bed at Home, LLC Home health agency, Grand Rapids, MI, CCN 237203
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301074143MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Valley Medical Specialists PLC Internal Medicine CurrentSince Jun 1, 2025 Accepting new patients

Locations

1000 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 459-3158

2093 Health Dr SW
Ste 200
Wyoming, MI 49519
Phone (616) 459-3158

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1700825296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DR SW STE 200",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199691",
            "telephone_number": "616-459-3158",
            "fax_number": "616-988-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DR SW STE 200",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199691",
            "telephone_number": "616-459-3158",
            "fax_number": "616-819-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIBBE",
        "first_name": "JEFFRY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301074143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.