Individual provider Active NPI

Danita Grace Vanderkodde, PA-C

  • Physician Assistant
  • Zeeland, MI
National Provider Identifier
1891996294
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003191 Issued in MI
Practice address
8333 Felch St Ste 300
Zeeland, MI 49464-2609
Phone
(616) 267-7104
NPI assigned
May 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003191 MI Primary

Addresses

Primary practice location

8333 Felch St Ste 300
Zeeland, MI 49464-2609

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dvanderkodde20654@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080902000210 MI Practitioner - Physician Assistant 9234205022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone (616) 267-8700

8333 Felch St
Zeeland, MI 49464-2609

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601003191MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2009 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2009 Accepting new patients
Infusion Associates PLLC PastSince Apr 1, 2002 Accepting new patients

Locations

2750 E Beltline Ave NE
Fl 3
Grand Rapids, MI 49525
Phone (616) 447-5820

275 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7900

2855 Michigan St NE
Ste 200
Grand Rapids, MI 49506
Phone (616) 957-4090

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

1840 Wealthy St SE
Grand Rapids, MI 49506
Phone (616) 391-1730

2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015

8333 Felch St
Ste 300
Zeeland, MI 49464
Phone (616) 267-9823

Interoperability endpoints

  • Direct secure messaging: dvanderkodde20654@epic00.shdirect.org
  • Direct secure messaging: dvanderkodde20654@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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1891996294",
    "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": "8333 FELCH ST STE 300",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494642609",
            "telephone_number": "616-267-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKODDE",
        "first_name": "DANITA",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dvanderkodde20654@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "2750 E Beltline Ave NE Fl 3",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495258614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2750 E Beltline Ave NE Fl 3",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495258614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Zeeland, MI

Sources for this page

Verify at the official NPI Registry.