NPIMap

Organization Active NPI

Spectrum Health Primary Care Partners

  • Pediatric Neurodevelopmental Disabilities Physician
  • Muskegon, MI
National Provider Identifier
1982904587
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Practice address
550 W Grand Ave
Muskegon, MI 49441-2336
Phone
(616) 391-2242
NPI assigned
Oct 28, 2010
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH PRIMARY CARE PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Lis McKinch
Title
SVP Finance
Phone
(616) 486-2253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0008X Primary

Addresses

Primary practice location

550 W Grand Ave
Muskegon, MI 49441-2336

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other names 1

  • Corewell Health Medical Group West Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health Partners197 organizations share this tax ID, including this one
Part of
Spectrum Health Partners

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1982904587",
    "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": "550 W GRAND AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494412336",
            "telephone_number": "616-391-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "enumeration_date": "2010-10-28",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "MCKINCH",
        "authorized_official_first_name": "LIS",
        "authorized_official_title_or_position": "SVP FINANCE",
        "authorized_official_telephone_number": "616-486-2253"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Medical Group West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.