Individual provider Active NPI

Margaret Vandewater, NP

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1902275506
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704263655 Issued in MI
Practice address
245 Cherry St SE
Suite 100
Grand Rapids, MI 49503-4607
Phone
(616) 685-3200
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704263655 MI Primary

Addresses

Primary practice location

245 Cherry St SE
Suite 100
Grand Rapids, MI 49503-4607

Mailing address

1900 44TH St SE
Kentwood, MI 49508-5008
Phone (616) 685-8348

Other names 1

  • Margaret Vanderwater Former name

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
I20151005000725 MI Practitioner - Nurse Practitioner 5294043642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

475 S State St
Sparta, MI 49345-1549
Phone (616) 685-1300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704263655MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Advantage Health Saint Mary's Medical Group Nurse Practitioner CurrentSince Nov 1, 2015 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 1, 2015 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

245 Cherry St SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 685-3200

1471 E Beltline Ave NE
Ste 201
Grand Rapids, MI 49525
Phone (616) 685-8620

1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500

475 S State St
Sparta, MI 49345
Phone (616) 685-1300

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 1

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": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1902275506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008",
            "telephone_number": "616-685-8348",
            "fax_number": "616-685-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CHERRY ST SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034607",
            "telephone_number": "616-685-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEWATER",
        "first_name": "MARGARET",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704263655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGARET",
            "last_name": "VANDERWATER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.