Kimberly Tew, PA
Individual provider Active NPI Physician Assistant · Coopersville, MI
NPI 1902990583 · NPPES record last updated Mar 3, 2021
Key facts
- NPI
- 1902990583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601003450 (MI)
- Practice address
- 25 Conran Dr
Suite B
Coopersville, MI 49404-1366 - Phone
- (616) 267-7860
- Fax
- (616) 267-7861
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Spectrum Health Primary Care Partners
Practice addresses (Care Compare)
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
Hospital & facility affiliations
- Spectrum Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031201000769 | MI | Practitioner - Physician Assistant | 9335044536 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003450 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current |
Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current |
Accepting new patients | |
| Spectrum Health Hospitals | Past | Accepting new patients |
Locations
25 Conran Dr
Ste B
Coopersville, MI 49404
Phone (616) 267-7860
100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680
2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015
2332 Alpine Ave NW
Grand Rapids, MI 49544
Phone (616) 363-3311
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600
4075 32nd Ave
Hudsonville, MI 49426
Phone (616) 229-9310
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
3350 Broadmoor Ave SE
Kentwood, MI 49512
Phone (616) 391-2778
6105 Wilson Ave SW
Wyoming, MI 49418
Phone (616) 486-5055
Interoperability endpoints
- ktew50980@epic00.corewelldirect.org
- ktew50980@epic00.shdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003450 | MI | Yes |
Addresses
Primary practice location
25 Conran Dr
Suite B
Coopersville, MI 49404-1366
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ktew50980@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ |
Other providers in Coopersville, MI
- Steven A Speet
- Jason Patrick Stark
- Jessica Susan Steenstra
- Marcia Joy Stonehouse
- Morgan Jean Sundblad Hsieh
- Cheryl Ann Thomas
- Krista Tisdel
- Uplift Therapies, LLC
- Kara Lynne Vanderboon
- Nicole Marie Vandussen
All providers in Coopersville, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.