Active NPI
Janelle Stutzman, MD
- Pediatrics Physician
- Caledonia, MI
National Provider Identifier
1811944945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301071054
- Practice address
- 7150 Kalamazoo Ave SE Ste a
Caledonia, MI 49316-9197 - Phone
- (616) 818-7454
- Fax
- (616) 818-7455
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301071054 | MI | Primary |
Addresses
Primary practice location
7150 Kalamazoo Ave SE Ste a
Caledonia, MI 49316-9197
Mailing address
7150 Kalamazoo Ave SE Ste a
Caledonia, MI 49316-9197
Phone (616) 818-7454
Other practice location 1
1545 68th St
Suite 100
Grand Rapids, MI 49508
Phone (616) 534-9881
Other practice location 2
4540 Kalamazoo Ave SE
Grand Rapids, MI 49508
Phone (616) 818-7454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301071054 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mikids Pediatrics, PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- jstutzman9127@epic00.corewelldirect.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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665446400000",
"number": "1811944945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7150 KALAMAZOO AVE SE STE A",
"city": "CALEDONIA",
"state": "MI",
"postal_code": "493169197",
"telephone_number": "616-818-7454",
"fax_number": "616-818-7455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7150 KALAMAZOO AVE SE STE A",
"city": "CALEDONIA",
"state": "MI",
"postal_code": "493169197",
"telephone_number": "616-818-7454",
"fax_number": "616-818-7455"
}
],
"practiceLocations": [
{
"address_1": "1545 68th St",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "49508",
"country_code": "US",
"telephone_number": "616-534-9881",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4540 Kalamazoo Ave SE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "49508",
"country_code": "US",
"telephone_number": "616-818-7454",
"fax_number": "616-818-7455",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STUTZMAN",
"first_name": "JANELLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2022-10-11",
"certification_date": "2022-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301071054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caledonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.