Active NPI
Jeff Alan Gietzen, FNP
- Family Nurse Practitioner
- Holland, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704287280
- Practice address
- 588 E Lakewood Blvd FL 2
Holland, MI 49424-2023 - Phone
- (616) 494-5810
- NPI assigned
- Nov 6, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704287280 | MI | Primary |
Addresses
Primary practice location
588 E Lakewood Blvd FL 2
Holland, MI 49424-2023
Mailing address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
4100 Lake Dr SE
Grand Rapids, MI 49546-8292
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
588 E Lakewood Blvd FL
Holland, MI 49424-2023
602 Michigan Ave
Suite 102
Holland, MI 49423-4918
Phone (616) 494-8724
8333 Felch St
Zeeland, MI 49464-2608
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Lakewood Family Medicine PLC | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients |
Locations
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
382 N 120th Ave
Holland, MI 49424
Phone (616) 396-6516
588 E Lakewood Blvd
Fl 2
Holland, MI 49424
Phone (616) 494-5800
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
Interoperability endpoints
- jgietzen244708@epic00.corewelldirect.org
Organizations & group practices 3
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.
-
dba Corewell Health Medical Group West
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
- Family Medicine Physician
- Holland, MI
- NPI 1073609392
-
dba Corewell Health Medical Group West
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Holland Hospital
- General Acute Care Hospital
- Holland, MI
- NPI 1871672618
-
dba Corewell Health Pennock Hospital
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
dba Corewell Health Grand Rapids Hospital
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
-
dba Corewell Health Zeeland Hospital
- General Acute Care Hospital
- Zeeland, MI
- NPI 1275536344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1871061085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE # MC845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "588 E LAKEWOOD BLVD FL 2",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494242023",
"telephone_number": "616-494-5810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIETZEN",
"first_name": "JEFF",
"middle_name": "ALAN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-06",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704287280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.