Individual provider Active NPI

Russell E Dempsey, MD

  • Family Medicine Physician
  • Hudsonville, MI
National Provider Identifier
1720160872
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301056447 Issued in MI
Practice address
4700 32ND Ave
Hudsonville, MI 49426-8001
Phone
(616) 662-2011
Fax
(616) 662-2222
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301056447 MI Primary

Addresses

Primary practice location

4700 32ND Ave
Hudsonville, MI 49426-8001

Mailing address

4700 32ND Ave
Hudsonville, MI 49426-8001
Phone (616) 662-2011

Other identifiers 1

IdentifierTypeStateIssuer
4084994MedicaidMI

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
I20100708000911 MI Practitioner - Family Practice 1759327943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partners in Family Health PLCGroup PAC ID 5597701789, 7 clinicians

Practice addresses (Care Compare)

4700 32ND Ave
Hudsonville, MI 49426-8001
Phone (616) 662-2011

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301056447MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Partners in Family Health PLC Family Medicine CurrentSince Mar 7, 1999 Accepting new patients

Locations

4700 32nd Ave
Hudsonville, MI 49426
Phone (616) 662-2011

Organizations & group practices 1

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 3

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1720160872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 32ND AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268001",
            "telephone_number": "616-662-2011",
            "fax_number": "616-662-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 32ND AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268001",
            "telephone_number": "616-662-2011",
            "fax_number": "616-662-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMPSEY",
        "first_name": "RUSSELL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301056447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4084994",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudsonville, MI

Sources for this page

Verify at the official NPI Registry.