NPIMap

Organization Active NPI

Spectrum Health Primary Care Partners

  • Maternal & Fetal Medicine Physician
  • Cadillac, MI
National Provider Identifier
1992204135
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Doing business as
Corewell Health Medical Group West
Spectrum Health Medical Group
Practice address
7985 Mackinaw TRL
Cadillac, MI 49601-8111
Phone
(616) 391-3681
NPI assigned
Feb 2, 2018
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
Leisa Kimbrough
Title
Senior Director
Phone
(616) 486-6579

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X Primary
Pediatric Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0205X

Addresses

Primary practice location

7985 Mackinaw TRL
Cadillac, MI 49601-8111

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other names 2

  • Corewell Health Medical Group West Doing business as
  • Spectrum Health Medical Group 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 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": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1992204135",
    "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",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7985 MACKINAW TRL",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018111",
            "telephone_number": "616-391-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH PRIMARY CARE PARTNERS",
        "enumeration_date": "2018-02-02",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "KIMBROUGH",
        "authorized_official_first_name": "LEISA",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "616-486-6579"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Medical Group West",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cadillac, 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.