Family Practice Associates of West Michigan P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MI 5101009001 Issued in MI

Legal business name

FAMILY PRACTICE ASSOCIATES OF WEST MICHIGAN P.C.

Practice address

6735 Cascade Rd SE
Suite 100
Grand Rapids, MI 49546-6887

Phone

(616) 975-2550

Fax

(616) 975-2555

NPI assigned

Aug 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Seth Vanwormer, D.O.

Title

Owner, President

Phone

(616) 975-2550

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1801101985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6735 CASCADE RD SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466887",
            "telephone_number": "616-975-2550",
            "fax_number": "616-975-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 CASCADE RD SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466887",
            "telephone_number": "616-975-2550",
            "fax_number": "616-975-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE ASSOCIATES OF WEST MICHIGAN P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "VANWORMER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "SETH",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "616-975-2550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "MI 5101009001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ON13300",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Xuejing Fan
• Jada Fannin

• Primary Care Clinic/Center in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.