Grand River Surgery, PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5101014347 Issued in MI

Legal business name

GRAND RIVER SURGERY, PLLC

Practice address

2093 Health Drive SW
Suite 300
Wyoming, MI 49519

Phone

(616) 532-8100

Fax

(616) 532-8200

NPI assigned

Aug 30, 2006

Last updated

Nov 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jaret Beane, DONPI 1972537876

Title

Owner

Phone

(616) 532-8100

Specialties & licenses 1

Addresses

Locations

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.

• Jaret A Beane, DO

  • Surgery Physician
  • Wyoming, MI
  • NPI 1972537876
  NPD (past) Authorized official
• John Timothy Morris, D.O.

  • Vascular Surgery Physician
  • Wyoming, MI
  • NPI 1982819611
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1790894822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DRIVE SW",
            "address_2": "SUITE 300",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-532-8100",
            "fax_number": "616-532-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DRIVE SW",
            "address_2": "SUITE 300",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-532-8100",
            "fax_number": "616-532-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RIVER SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "BEANE",
        "authorized_official_first_name": "JARET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-532-8100",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101014347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Gene Graham, RT(R)
• Kerry Graham
• Kristy Graham
• Grand Rapids Medical Center Inc
• Grand Rapids Surgical Associates, PLLC
• Grandville Dental Health Center PC
• Great Lakes Healthcare Resources-Lakeshore LLC
• Great Lakes Healthcare Resources, LLC
• Great Lakes Home Modification LLC
• Great Lakes Injury Recovery

• Surgery Physician in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.