SPECTRUM HEALTH PRIMARY CARE PARTNERS (NPI# 1275190456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275190456 |
| Entity Type | Organization |
| Organization Name | SPECTRUM HEALTH PRIMARY CARE PARTNERS |
| Practice Address |
5500 Clyde Park Ave Sw Wyoming MI 49509-9525 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6164866790 |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |
| Authorized Official Name | ADRIENNE BRYAN (DIRECTOR, FINANCE) |
| Authorized Official Telephone | 6166439123 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPECTRUM HEALTH PRIMARY CARE PARTNERS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Spectrum Health Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154458 | Spectrum Health Primary Care Partners | Internal Medicine | 749 Phillips St, South Haven, MI 49090-1842 | 2020-11-05 |
| 1740810563 | Spectrum Health Primary Care Partners | Family Medicine | 435 Ionia Ave Sw, Grand Rapids, MI 49503-5161 | 2020-01-21 |
| 1811554090 | Spectrum Health Primary Care Partners | Assisted Living Facility | 3391 Prairie St Sw, Grandville, MI 49418-1992 | 2019-05-23 |
| 1033774054 | Spectrum Health Primary Care Partners | Internal Medicine | 1725 Port Sheldon St, Jenison, MI 49428-9002 | 2019-05-06 |
| 1033619135 | Spectrum Health Primary Care Partners | Physical Therapist | 6201 68th St Se, Caledonia, MI 49316 | 2018-02-15 |
| 1457850802 | Spectrum Health Primary Care Partners | Physician Assistant | 4075 32nd Ave, Hudsonville, MI 49426 | 2018-02-12 |
| 1376077453 | Spectrum Health Primary Care Partners | Internal Medicine | 8501 Meadowcreek Dr, Rockford, MI 49341 | 2017-04-17 |
| 1346698784 | Spectrum Health Primary Care Partners | Internal Medicine | 2009 Holton Road, Muskegon, MI 49445 | 2016-05-26 |
| 1669854816 | Spectrum Health Primary Care Partners | Obstetrics & Gynecology | 4249 Parkway Place Dr Sw, Grandville, MI 49418-2679 | 2015-06-24 |
| 1306224563 | Spectrum Health Primary Care Partners | Internal Medicine | 1845 Holton Rd, Muskegon, MI 49445-1531 | 2015-05-08 |
| Street Address |
5500 CLYDE PARK AVE SW |
| City | WYOMING |
| State | MI |
| Zip Code | 49509-9525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497706840 | Metro Health Basic Care | Nurse Practitioner | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2006-05-12 |
| 1497309751 | Julie Ann Dragt | Nurse Practitioner | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2019-07-25 |
| 1326691791 | Kory Allen Eastway | Nurse Practitioner | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2019-07-24 |
| 1467005165 | Andrea Lynn Eastway | Nurse Practitioner | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2019-07-22 |
| 1528611373 | Erin Jean Mccue | Nurse Practitioner | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2019-07-22 |
| 1750946927 | Jonathan Skutnick | Pharmacist | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2019-05-03 |
| 1063998854 | Hayden Larson | Optometrist | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2018-07-14 |
| 1285128280 | Samuel Ryan Mccollum | Pharmacist | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2018-06-22 |
| 1841712924 | Brittany Huffman | Pharmacist | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2017-07-11 |
| 1659771723 | Samantha J Jones | Pharmacist | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2014-08-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023620713 | Lindsay Kayann Ottowitz | Behavior Technician | 1428 44th St. Sw, Wyoming, MI 49509 | 2020-08-23 |
| 1750990016 | Lindsay Alexandra Lyszczarz | Behavior Technician | 5281 Clyde Park Ave Se, Suite 2, Wyoming, MI 49509 | 2020-07-23 |
| 1033690409 | Courtney M Garner | Behavior Technician | 1428 44th Street, Wyoming, MI 49509 | 2018-08-23 |
| 1457857195 | Ashley Mae Autio | Case Manager/Care Coordinator | 795 36th Street, Wyoming, MI 49509 | 2018-04-02 |
| 1689124588 | Jacqeulyn Harmon | Behavioral Analyst | 2819 Peckheath Rd Sw Apt D, Wyoming, MI 49509 | 2016-10-04 |
| 1275988925 | Intsar Abdulahe | Social Worker | 1551 Charles Russell, Wyoming, MI 49509 | 2016-05-02 |
| 1992160071 | Concierge Home Care Services of West Michigan, LLC | Home Infusion | 1360 56th Street Sw, Wyoming, MI 49509 | 2015-12-16 |
| 1417349796 | Yashana Duncan | Case Manager/Care Coordinator | 225 Colrain St. Sw, Suite 2, Wyoming, MI 49509 | 2015-02-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| 1366882755 | Kevin Timothy Solt | Dentist | 1535 44th St Sw Ste 200, Wyoming, MI 49509 | 2013-06-28 |
| Find all providers in zip 49509 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
| 1710368782 | Tracie Medrano- Smith | Family Medicine | 4174 56th St Sw, Wyoming, MI 49418 | 2015-06-15 |
| 1174863930 | Tom Cohen | Family Medicine | 105 Church Rd, Rd#3, Wyoming, PA 18644-9329 | 2013-02-15 |
| 1235225293 | Richard J Stang | Family Medicine | 3011 Sandy Ct Sw, Wyoming, MI 49418-8736 | 2006-10-05 |
| 1528168986 | Sunforest Family Medicine, Plc | Family Medicine | 3020 Waterchase Way Sw, Apt. 304, Wyoming, MI 49519-5997 | 2006-09-25 |
| 1609801570 | Natalie D Williams | Family Medicine | 3020 Wasterchase Way, Apt 304, Wyoming, MI 49519 | 2006-07-11 |
| 1912950155 | Elizabeth A Boessenkool | Family Medicine | 950 36th St Sw, Wyoming, MI 49509-3587 | 2006-05-18 |
| 1760430524 | Remigijus Satkauskas | Family Medicine | 101 S Galena Ave, Wyoming, IL 61491-1470 | 2006-05-04 |
| 1598735961 | Medical Associates of Maquoketa PC | Family Medicine | 307 E Webster St, Wyoming, IA 52362 | 2006-01-26 |
| 1619973559 | Toni Jo Parmelee | Family Medicine | 214 Wyoming Ave, Wyoming, PA 18644-1619 | 2005-06-24 |
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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.