Individual provider Active NPI

Meagan Ann Smith, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1811336324
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101020715 Issued in MI
Practice address
235 Wealthy St SE Ste 100
Grand Rapids, MI 49503-5229
Phone
(616) 840-8000
NPI assigned
Jun 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101020715 MI Primary

Addresses

Primary practice location

235 Wealthy St SE Ste 100
Grand Rapids, MI 49503-5229

Mailing address

235 Wealthy St SE Ste 100
Grand Rapids, MI 49503-5229
Phone (616) 840-8000

Other practice location 1

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-1000

Other identifiers 1

IdentifierTypeStateIssuer
1811336324MedicaidMI

Other names 1

  • Meagan Ann Putnam Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msmith90334@direct.covenanthealthcare.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171018000330 MI Practitioner - Physical Medicine and Rehabilitation 7012283153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 242-0422

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101020715MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Rehabilitation Hospital CurrentSince Nov 1, 2017 Accepting new patients

Locations

235 Wealthy St SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 493-9724

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

Interoperability endpoints

  • Direct secure messaging: msmith40725@direct.trinity-health.org

Organizations & group practices 1

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 5

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": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1811336324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035229",
            "telephone_number": "616-840-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035229",
            "telephone_number": "616-840-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121811",
            "country_code": "US",
            "telephone_number": "517-364-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MEAGAN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101020715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811336324",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msmith90334@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "235 Wealthy St SE Ste 100",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495035229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEAGAN",
            "last_name": "PUTNAM",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.