NPIMap

Organization Active NPI

Spectrum Health Primary Care Partners

  • Geriatric Medicine (Internal Medicine) Physician
  • Holland, MI
National Provider Identifier
1780986018
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Practice address
727 Apple Ave
Holland, MI 49423-5405
Phone
(616) 392-4650
NPI assigned
Nov 18, 2010
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH PRIMARY CARE PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Authorized official

Name
Pauline Krywanski
Title
SVP
Phone
(616) 486-2253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

727 Apple Ave
Holland, MI 49423-5405

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

National Provider Directory

National Provider Directory
Part of
Spectrum Health Partners

NPI Registry JSON

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1780986018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 APPLE AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235405",
            "telephone_number": "616-392-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.