Individual provider Active NPI

Shelley Ann Meyerholtz, NP

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1992252795
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704271335 Issued in MI
Practice address
1900 Wealthy St SE Ste 200
Grand Rapids, MI 49506-2969
Phone
(616) 774-0276
NPI assigned
Sep 9, 2016
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704271335 MI Primary

Addresses

Primary practice location

1900 Wealthy St SE Ste 200
Grand Rapids, MI 49506-2969

Mailing address

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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address smeyerholtz118200@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161018002780 MI Practitioner - Nurse Practitioner 4587952981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Health HospitalsGroup PAC ID 8921904764, 161 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

100 Michigan St Northeast
Corewell Health Grand Rapids Hospit
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

230 W Oak St
1 Surgical Optimization Center
Fremont, MI 49412-1526
Phone (616) 267-9823

705 Oak St
Unit 1
Big Rapids, MI 49307-3109
Phone (616) 267-9823

705 S Greenville W Dr
202 Surgical Optimization Center
Greenville, MI 48838-3530
Phone (616) 267-9823

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704271335MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Nov 13, 2016 Accepting new patients
Spectrum Health Hospitals CurrentSince Nov 1, 2021 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Nov 13, 2016 Accepting new patients
Spectrum Health Hospitals CurrentSince Nov 1, 2021 Accepting new patients

Locations

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

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

1900 Wealthy St SE
Ste 200
Grand Rapids, MI 49506
Phone (616) 459-0292

2900 Bradford St NE
Grand Rapids, MI 49525

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

7 Atkinson Dr
Ste 302
Ludington, MI 49431
Phone (231) 268-0302

Interoperability endpoints

  • Direct secure messaging: smeyerholtz118200@epic00.corewelldirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1992252795",
    "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": "1900 WEALTHY ST SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062969",
            "telephone_number": "616-774-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERHOLTZ",
        "first_name": "SHELLEY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704271335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smeyerholtz118200@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "2900 Bradford St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495256427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2900 Bradford St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495256427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.