NPIMap

Organization Active NPI

Spectrum Health Hospital-CNP

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1841430600
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SPECTRUM HEALTH HOSPITAL-CNP
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 391-1774
NPI assigned
Mar 5, 2009
Last updated
Mar 6, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Authorized official

Name
Brian Dessoy
Title
Senior Director BSC
Phone
(616) 643-9145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560

Other identifiers 1

IdentifierTypeStateIssuer
0D11130OtherMIBCBS GROUP PIN 0D11130

National Provider Directory

National Provider Directory
Tax ID family
Grand Rapids Pediatrics87 organizations share this tax ID, including this one
Part of
Grand Rapids Pediatrics

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1841430600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITAL-CNP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH HOSPITAL",
        "enumeration_date": "2009-03-05",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "DESSOY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "SENIOR DIRECTOR BSC",
        "authorized_official_telephone_number": "616-643-9145"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PIN 0D11130",
            "identifier": "0D11130",
            "state": "MI"
        }
    ],
    "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 Mar 6, 2009; 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.