Organization Active NPI

Western Michigan Pediatric Cardiology Assoc

  • Pediatric Cardiology Physician
  • Grand Rapids, MI
National Provider Identifier
1831293190
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
WESTERN MICHIGAN PEDIATRIC CARDIOLOGY ASSOC
Practice address
330 Barclay NE
#201
Grand Rapids, MI 49503
Phone
(616) 459-8247
Fax
(616) 459-0034
NPI assigned
Sep 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Cyndi L Mansfield
Title
Office Supervisor
Phone
(616) 459-8247

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

330 Barclay NE
#201
Grand Rapids, MI 49503

Mailing address

330 Barclay NE
#201
Grand Rapids, MI 49503
Phone (616) 459-8247

National Provider Directory

National Provider Directory

Locations

330 Barclay Ave NE
Ste 201
Grand Rapids, MI 49503
Phone (616) 459-8247

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831293190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BARCLAY NE",
            "address_2": "#201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-459-8247",
            "fax_number": "616-459-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BARCLAY NE",
            "address_2": "#201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-459-8247",
            "fax_number": "616-459-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MICHIGAN PEDIATRIC CARDIOLOGY ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANSFIELD",
        "authorized_official_first_name": "CYNDI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "616-459-8247",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.