NPIMap

Organization Active NPI

Spectrum Health Hospitals

  • Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1992007660
Registry record updated Mar 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SPECTRUM HEALTH HOSPITALS
Practice address
145 Michigan St NE
Grand Rapids, MI 49503-2562
Phone
(616) 486-6333
NPI assigned
Dec 1, 2010
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2015

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

Authorized official

Name
Polly Krywanski
Title
SVP of Finance
Phone
61648622553

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0801X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X

Addresses

Primary practice location

145 Michigan St NE
Grand Rapids, MI 49503-2562

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

National Provider Directory

National Provider Directory
Tax ID family
Grand Rapids Pediatrics86 organizations share this tax ID, including this one
Part of
Grand Rapids Pediatrics

Organizations with this tax ID in the same state 12

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

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426291200000",
    "number": "1992007660",
    "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",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032562",
            "telephone_number": "616-486-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH HOSPITALS",
        "enumeration_date": "2010-12-01",
        "last_updated": "2015-03-14",
        "status": "A",
        "authorized_official_last_name": "KRYWANSKI",
        "authorized_official_first_name": "POLLY",
        "authorized_official_title_or_position": "SVP OF FINANCE",
        "authorized_official_telephone_number": "61648622553"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2015; 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.