NPIMap

Organization Active NPI

Patient One Care, PLLC

  • Urgent Care Clinic/Center
  • Grand Rapids, MI
National Provider Identifier
1770934325
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PATIENT ONE CARE, PLLC
Practice address
1740 28TH St SE
Grand Rapids, MI 49508-1414
Phone
(616) 200-8669
Fax
(616) 552-1618
NPI assigned
Jun 24, 2016
Last updated
May 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Dr. Jobeda A Sheuly, MDNPI 1568415677
Title
Owner
Phone
(616) 323-3999

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
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

1740 28TH St SE
Grand Rapids, MI 49508-1414

Mailing address

1740 28TH St SE
Grand Rapids, MI 49508-1414
Phone (616) 323-3999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170124001540 MI Part B Supplier - Clinic/Group Practice 1658653860 Receives reassigned benefits from 15 practitioners
4 other NPIs on this enrollment
Practice locations: Grand Rapids, MI; Grandville, MI; Holland, MI; Jenison, MI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2871 44th St SW
Grandville, MI 49418
Phone (616) 410-7420

345 Baldwin St
Jenison, MI 49428
Phone (616) 294-8881

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1770934325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 28TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495081414",
            "telephone_number": "616-323-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 28TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495081414",
            "telephone_number": "616-200-8669",
            "fax_number": "616-552-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENT ONE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "SHEULY",
        "authorized_official_first_name": "JOBEDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-323-3999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 14, 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.