DERM INSTITUTE OF WEST MICHIGAN PLC (NPI# 1003460874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003460874 |
| Entity Type | Organization |
| Organization Name | DERM INSTITUTE OF WEST MICHIGAN PLC |
| Practice Address |
6750 Kalamazoo Ave Suites C & D Grand Rapids MI 49508 |
| Mailing Address |
7234 Tory Dr Hudsonville MI 49426-9066 |
| Practice Telephone | 7406067403 |
| Mailing Telephone | 6164852012 |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-30 |
| Authorized Official Name | DR. KRISTI BETH HAWLEY (SOLE MBR) |
| Authorized Official Telephone | 7406067403 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| DERM INSTITUTE | Doing Business As Name - Organization |
| Street Address |
6750 KALAMAZOO AVE SUITES C & D |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012367 | Jenna Brianne Labrecque | Social Worker | 2013 East Castle Dr, Suite B, Kentwood, MI 49508 | 2020-10-27 |
| 1881208809 | Morgan Paige Ballmann | Physical Therapy Assistant | 4150 Kalamazoo Ave. Se, Grand Rapids, MI 49508 | 2020-09-08 |
| 1699385740 | Jodie Lynn Robertson | Prosthetist | 3720 Eastern Se, Grand Rapids, MI 49508 | 2020-08-04 |
| 1255801833 | Ikeia Tynika Hill | Licensed Practical Nurse | 1627 Lotus, Grand Rapids, MI 49508 | 2018-11-27 |
| 1326556838 | Araceli Contreras-hernandez | Behavior Technician | 3566 Eastern Ave. Se, Kentwood, MI 49508 | 2018-01-18 |
| 1881102788 | A Grand Rapids Senior Social Exchange and Adult Day Center | In Home Supportive Care | 3212 Eastern Ave Se, Grand Rapids, MI 49508 | 2018-01-14 |
| 1952827107 | Nupoint Services LLC | Clinic/Center | 1620 44th Street Se, Grand Rapids, MI 49508 | 2017-08-19 |
| 1710427695 | Embracing Life Afc | Custodial Care Facility | 1405 Forrester St S.e., Grand Rapids, MI 49508 | 2017-02-27 |
| 1083162838 | Katherine Berenice Campoverde Arevalo | Technician, Other | 1157 Billigs Ct Se, Ap# 1a, Grand Rapids, MI 49508 | 2016-09-21 |
| 1902265234 | Lauren Conkright | Psychologist | 1009 44th St Se, Suite 103, Grand Rapids, MI 49508 | 2016-02-15 |
| Find all providers in zip 49508 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306289574 | Nicholas Michael Bontumasi | Dermatology | 4362 Cascade Road Se, Grand Rapids, MI 49546-3631 | 2013-04-08 |
| 1821350745 | Kristi B Hawley | Dermatology | 6750 Kalamazoo Ave Se Ste C, Grand Rapids, MI 49508-7897 | 2012-06-15 |
| 1437380102 | Adam D Asarch | Dermatology | 4362 Cascade Rd Se, Suite 206, Grand Rapids, MI 49546-3600 | 2009-07-29 |
| 1588783419 | Dara Spearman | Dermatology | 4352 Cascade Road, Suite 206, Grand Rapids, MI 49546-3631 | 2007-03-29 |
| 1962595199 | Howard Alan Beadner | Dermatology | 2124 Woodcliff Ave. Se, Grand Rapids, MI 49546-5711 | 2006-10-02 |
| 1508960253 | Robert W Stokes | Dermatology | 1815 Breton Rd Se, Suite C1, Grand Rapids, MI 49506 | 2006-09-12 |
| 1649260688 | Richard J Ashack | Dermatology | 1740 E Paris Ave Se, Grand Rapids, MI 49546-6204 | 2005-10-21 |
| 1073976338 | Kurt Ashack | Dermatology | 1740 E Paris Ave Se, Grand Rapids, MI 49546-6204 | 2016-04-03 |
| 1376924902 | David Oberlin | Dermatology | 4362 Cascade Rd Se Ste 206, Grand Rapids, MI 49546 | 2015-06-09 |
| 1417362120 | Juri Bassuner | Dermatology | 25 Michigan St Ne, Grand Rapids, MI 49503-2515 | 2014-06-23 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49508 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.