NPIMap

Organization Active NPI

Spectrum Health Sleep Disorders Center

  • Other Specialist/Technologist
  • Grand Rapids, MI
National Provider Identifier
1841541307
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
License
15206 Issued in MI
Legal business name
SPECTRUM HEALTH SLEEP DISORDERS CENTER
Practice address
4100 Lake Dr SE
Suite 100
Grand Rapids, MI 49546-8292
Phone
(616) 391-3759
Fax
(616) 267-8232
NPI assigned
Sep 25, 2012
Last updated
Sep 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Authorized official

Name
Ms. De Metria M Clark, RPSGT
Title
Care Management Coordinator
Phone
(616) 391-3759

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X 15206 MI Primary

Addresses

Primary practice location

4100 Lake Dr SE
Suite 100
Grand Rapids, MI 49546-8292

Mailing address

4100 Lake Dr SE
Suite 100
Grand Rapids, MI 49546-8292
Phone (616) 391-3759

National Provider Directory

National Provider Directory
Tax ID family
BMMC Ferguson Clinic198 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1841541307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-391-3759",
            "fax_number": "616-267-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-391-3759",
            "fax_number": "616-267-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH SLEEP DISORDERS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DE METRIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CARE MANAGEMENT COORDINATOR",
        "authorized_official_telephone_number": "616-391-3759",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPSGT"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "MI",
            "license": "15206",
            "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 Sep 25, 2012; 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.