Nancy A Wolotira, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704081078 Issued in MI

Practice address

300 Lafayette Ave SE
Grand Rapids, MI 49503-4600

Phone

(616) 732-3098

Fax

(616) 732-3095

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saint Mary's Health Services

  dba Mercy Health Saint Mary's

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  NPD (past)
• Trinity Health - Michigan

  dba Heartside Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1902002272
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982623633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034328",
            "telephone_number": "616-913-1808",
            "fax_number": "616-913-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LAFAYETTE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034600",
            "telephone_number": "616-732-3098",
            "fax_number": "616-732-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLOTIRA",
        "first_name": "NANCY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704081078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4577450",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4878598",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Alan Wolfson, M.D.
• Seth W Wolk, M.D.
• Kali Jo Wolken, LMHC, LPC
• Marli Wollet
• John Wolohan
• Leah Wolpert
• Isabella Gloria Wolschleger, CHW
• Kevin G Wolschleger, M.D.
• Adina Cornelia Wolter, LLMSW
• Jane Kathryn Wolterink

• Adult Health Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.