Organization Active NPI

Gynecologic Oncology of West Michigan, PLLC

  • Gynecologic Oncology Physician
  • Grand Rapids, MI
National Provider Identifier
1720292303
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
Legal business name
GYNECOLOGIC ONCOLOGY OF WEST MICHIGAN, PLLC
Practice address
1000 E Paris Ave SE
Suite 242
Grand Rapids, MI 49546-3691
Phone
(616) 957-3398
NPI assigned
May 10, 2007
Last updated
May 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Authorized official

Name
Kristi Knox Downey
Title
Practice Administrator
Phone
(616) 957-3539

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X Primary

Addresses

Primary practice location

1000 E Paris Ave SE
Suite 242
Grand Rapids, MI 49546-3691

Mailing address

1000 E Paris Ave SE
Suite 242
Grand Rapids, MI 49546-3691
Phone (616) 957-3398

Other identifiers 2

IdentifierTypeStateIssuer
0P51370001OtherMEDICARE PTAN
CK3413OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

1000 East Paris Ave SE
Ste 242
Grand Rapids, MI 49546
Phone (616) 957-3398

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369872000000",
    "number": "1720292303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE",
            "address_2": "SUITE 242",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463691",
            "telephone_number": "616-957-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE",
            "address_2": "SUITE 242",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463691",
            "telephone_number": "616-957-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GYNECOLOGIC ONCOLOGY OF WEST MICHIGAN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2013-05-30",
        "status": "A",
        "authorized_official_last_name": "DOWNEY",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "KNOX",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "616-957-3539"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0P51370001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK3413",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.