MRS. PATTI JO PECK (NPI# 1063473544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063473544 |
| Entity Type | Individual |
| Full Name | MRS. PATTI JO PECK |
| Other Name | MISS PATTI JO DYKEMA |
| Credential | NP |
| Practice Address |
200 Jefferson Se Grand Rapids MI 49503 |
| Mailing Address |
245 State St Se Ste 221 Grand Rapids MI 49503 |
| Practice Telephone | 6166855000 |
| Practice Fax Number | 6166853084 |
| Mailing Telephone | 6166851808 |
| Mailing Fax Number | 6166851850 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2009-07-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704151401 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
1494303 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 JEFFERSON SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023079159 | Wendi Alane Davidson | Registered Nurse | 200 Jefferson Se, Grand Rapids, MI 49503 | 2006-03-29 |
| 1306463872 | Patrick James Gidley | Radiology | 200 Jefferson Se, Jefferson Bldg Suite 305, Grand Rapids, MI 49503 | 2020-07-01 |
| 1841503851 | Grand Rapids Medical Education Partners | General Acute Care Hospital | 200 Jefferson Se, Grand Rapids, MI 49503 | 2010-07-19 |
| 1427280965 | Abdur Rehman | Internal Medicine | 200 Jefferson Se, Grand Rapids, MI 49503 | 2009-08-18 |
| 1255569653 | Aaron Edward Hampton | Internal Medicine | 200 Jefferson Se, Ste 626, Grand Rapids, MI 49503 | 2009-06-24 |
| 1811138852 | Carla Walker | Nurse Practitioner | 200 Jefferson Se, Grand Rapids, MI 49503 | 2009-03-22 |
| 1265689871 | Ann Elisabeth Victory | Internal Medicine | 200 Jefferson Se, Grand Rapids, MI 49503 | 2008-08-26 |
| 1679765986 | Ahmad Bilal Masood | Internal Medicine | 200 Jefferson Se, Ste 626, Grand Rapids, MI 49503 | 2007-08-10 |
| 1396944971 | Matthew Paul Biersack | Internal Medicine | 200 Jefferson Se, Ste 626, Grand Rapids, MI 49503 | 2007-07-13 |
| 1891903480 | Susan Marie Terrell | Internal Medicine | 200 Jefferson Se, Grand Rapids, MI 49503 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
| 1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
| 1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
| 1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
| 1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
| 1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
| 1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
| 1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
| 1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
| 1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
| Find all providers in zip 49503 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021358 | Cheryl Fowler | Nurse Practitioner | 523 Fontenelle St Se, Grand Rapids, MI 49548-7316 | 2019-09-05 |
| 1477049518 | Mark Contreras | Nurse Practitioner | 72 Sheldon Blvd Se # 130, Grand Rapids, MI 49504 | 2018-07-02 |
| 1811437817 | Embree Embracing Quality Care 'at Your Front Door' | Nurse Practitioner | 1735 Woodward Ave Se, Grand Rapids, MI 49506-4531 | 2017-02-24 |
| 1295083152 | Joanne P Sherwood | Nurse Practitioner | 703 Ball Ave, Grand Rapids, MI 49506 | 2012-08-27 |
| 1831416478 | Cheryl A Sisco | Nurse Practitioner | 200 Jefferson Ave., Grand Rapids, MI 49503 | 2010-04-21 |
| 1063742518 | Joanne Lois Jepsen | Nurse Practitioner | 2100 Raybrook Ave Se, Suite 300, Grand Rapids, MI 49546 | 2010-01-06 |
| 1356571749 | Cathleen Suzanne Bouwsma | Nurse Practitioner | 250 Fuller Ave Se, Grand Rapids, MI 49506-1675 | 2009-07-20 |
| 1497828214 | Jacob William Turmell | Nurse Practitioner | 2774 Birchcrest Dr Se, Grand Rapids, MI 49506 | 2006-11-17 |
| 1285666701 | Sarah Anne Akers | Nurse Practitioner | 25 Michigan St Ne Ste 2100, Grand Rapids, MI 49503-2526 | 2006-07-07 |
| 1083212245 | Jennifer Renee Jacobs | Nurse Practitioner | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2020-10-11 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on MRS. PATTI JO PECK.
| 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.