Active NPI
Spectrum Health Primary Care Partners
- Clinical Medical Laboratory
- Grand Rapids, MI
National Provider Identifier
1902111479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- SPECTRUM HEALTH PRIMARY CARE PARTNERS
- Practice address
- 1140 Monroe Ave NW
Suite 4102
Grand Rapids, MI 49503-1055 - Phone
- (616) 267-7810
- NPI assigned
- Aug 9, 2010
- Organization subpart
- Yes
- Parent organization
- SPECTRUM HEALTH PRIMARY CARE PARTNERS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pauline Krywanski
- Title
- SVP
- Phone
- (616) 486-2253
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
1140 Monroe Ave NW
Suite 4102
Grand Rapids, MI 49503-1055
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
National Provider Directory
National Provider Directory- Part of
- Spectrum Health Partners
Locations
1140 Monroe Ave NW
Ste 4
Grand Rapids, MI 49503
Phone (616) 974-4810
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Grand Rapids, MI
- NPI 1982645644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1297036800000",
"number": "1902111479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 MONROE AVE NW",
"address_2": "SUITE 4102",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031055",
"telephone_number": "616-267-7810"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
"enumeration_date": "2010-08-09",
"last_updated": "2011-02-07",
"status": "A",
"authorized_official_last_name": "KRYWANSKI",
"authorized_official_first_name": "PAULINE",
"authorized_official_title_or_position": "SVP",
"authorized_official_telephone_number": "616-486-2253"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
- Spectrum Health Primary Care Partners
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.