Individual provider Active NPI

Heather Joy Moss, NP

  • Adult Health Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1790035160
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704254589 Issued in MI
Practice address
145 Michigan St NE Ste 5120
Grand Rapids, MI 49503-2567
Phone
(616) 486-6314
Fax
(616) 486-6182
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704254589 MI Primary

Addresses

Primary practice location

145 Michigan St NE Ste 5120
Grand Rapids, MI 49503-2567

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address hmoss76233@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121116000117 MI Practitioner - Nurse Practitioner 5294986477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

145 Michigan St NE
4100 Corewell Health Medical Group West
Grand Rapids, MI 49503-2567
Phone (616) 486-6314

2249 Wealthy St SE
110 Corewell Health Medical Group West
East Grand Rapids, MI 49506-3055
Phone (616) 391-4600

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

5 Atkinson Dr
302 Corewell Health Medical Group West
Ludington, MI 49431-1906
Phone (616) 267-8700

615 S Bower St
Greenville, MI 48838-2614
Phone (616) 225-6522

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704254589MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Oct 15, 2012 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Oct 15, 2012 Accepting new patients

Locations

145 Michigan St NE
Ste 4100
Grand Rapids, MI 49503
Phone (616) 486-5993

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

145 Michigan St NE
Ste 5120
Grand Rapids, MI 49503
Phone (616) 486-6314

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: hmoss76233@epic00.corewelldirect.org

Organizations & group practices 2

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 6

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": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1790035160",
    "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": "145 MICHIGAN ST NE STE 5120",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032567",
            "telephone_number": "616-486-6314",
            "fax_number": "616-486-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "HEATHER",
        "middle_name": "JOY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704254589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hmoss76233@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "145 Michigan St NE",
            "address_2": "Suite 4100",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "145 Michigan St NE",
            "address_2": "Suite 4100",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.