Individual provider Active NPI

Kaleigh Marie Fetcko-Fayad, MD

  • Neurology Physician
  • Grand Rapids, MI
National Provider Identifier
1962906545
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301511327 Issued in MI
Practice address
145 Michigan St NE Ste 5200
Grand Rapids, MI 49503-2565
Phone
(616) 486-6700
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301511327 MI Primary

Addresses

Primary practice location

145 Michigan St NE Ste 5200
Grand Rapids, MI 49503-2565

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240624001841 MI Practitioner - Neurology 4486901873 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

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

145 Michigan St NE
5500 Corewell Health Medical Group West
Grand Rapids, MI 49503-2565
Phone (616) 267-8540

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Corewell Health Gerber Hospital Hospital, Fremont, MI, CCN 231338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Newaygo County General Hospital Association CurrentSince Jul 1, 2024 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince Jul 1, 2024 Accepting new patients
Reed City Hospital Corporation CurrentSince Apr 15, 2024 Accepting new patients
Spectrum Health United CurrentSince Jul 1, 2024 Accepting new patients
Spectrum Health United CurrentSince Jul 1, 2024 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince Jul 1, 2024 Accepting new patients
Pennock Hospital CurrentSince Jul 1, 2024 Accepting new patients
Newaygo County General Hospital Association CurrentSince Jul 1, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2024 Accepting new patients
Reed City Hospital Corporation CurrentSince Apr 15, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2024 Accepting new patients
Pennock Hospital CurrentSince Jul 1, 2024 Accepting new patients

Locations

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

230 W Oak St
Fremont, MI 49412
Phone (231) 924-1305

145 Michigan St NE
Ste 5200
Grand Rapids, MI 49503
Phone (616) 486-5933

25 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-0800

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

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

1009 W Green St
Hastings, MI 49058
Phone (269) 945-1212

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

300 N Patterson Rd
Reed City, MI 49677
Phone (231) 832-3271

4499 220th Ave
Reed City, MI 49677
Phone (231) 832-5817

Interoperability endpoints

  • Direct secure messaging: kfetckofayad17917@uihealth.direct-ci.com
  • Direct secure messaging: kfetckofaya2629171@epic00.corewelldirect.org

Organizations & group practices 12

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 3

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1962906545",
    "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": "145 MICHIGAN ST NE STE 5200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032565",
            "telephone_number": "616-486-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETCKO-FAYAD",
        "first_name": "KALEIGH",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301511327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.