NPIMap

Organization Active NPI

Rawm Vascular Access, PLLC

  • Nephrology Physician
  • Wyoming, MI
National Provider Identifier
1710378377
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
RAWM VASCULAR ACCESS, PLLC
Practice address
1540 36TH Street. SW
Wyoming, MI 49509
Phone
(616) 532-3072
Fax
(616) 532-4078
NPI assigned
Feb 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Michael J UnruhNPI 1104036532
Title
MD
Phone
(616) 532-3072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1540 36TH Street. SW
Wyoming, MI 49509

Mailing address

330 E Beltline NE
Suite 100
Grand Rapids, MI 49506-1208
Phone (616) 752-6235

Other identifiers 1

IdentifierTypeStateIssuer
1104036532MedicaidMI

Other names 1

  • RAWM VASCULAR ACCESS CENTER, PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150501001112 MI Part B Supplier - Clinic/Group Practice 3072832625 Receives reassigned benefits from 6 practitioners
Practice locations: Wyoming, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1710378377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E BELTLINE NE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061208",
            "telephone_number": "616-752-6235",
            "fax_number": "616-752-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 36TH STREET. SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49509",
            "telephone_number": "616-532-3072",
            "fax_number": "616-532-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAWM VASCULAR ACCESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "UNRUH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "616-532-3072"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104036532",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAWM VASCULAR ACCESS CENTER, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.