GRAND RAPIDS THORACIC SURGERY, PLLC (NPI# 1336504760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336504760 |
| Entity Type | Organization |
| Organization Name | GRAND RAPIDS THORACIC SURGERY, PLLC |
| Practice Address |
4500 Cascade Rd Se Suite 210 Grand Rapids MI 49546-3665 |
| Practice Telephone | 6162597341 |
| Practice Fax Number | 6162597642 |
| Mailing Telephone | 6162597341 |
| Mailing Fax Number | 6162597642 |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |
| Authorized Official Name | LOURENS J. WILLEKES II (OWNER) |
| Authorized Official Telephone | 6162597341 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4301104138 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
4500 CASCADE RD SE SUITE 210 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-3665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548283559 | Oral and Maxillofacial Surgery Services, Plc | Dentist | 4500 Cascade Rd Se, Suite #208, Grand Rapids, MI 49546-3665 | 2006-07-25 |
| 1932554995 | Forest Hills Dental, P.C. | Dentist | 4500 Cascade Rd Se, Ste. 107, Grand Rapids, MI 49546-3665 | 2016-04-27 |
| 1063826865 | Daniel Paul Lingenfelter | Dentist | 4500 Cascade Rd Se, Suite #107, Grand Rapids, MI 49546-3665 | 2014-06-19 |
| 1912165556 | Michel Marie Wicksall | Dentist | 4500 Cascade Rd Se, 200, Grand Rapids, MI 49546 | 2008-05-30 |
| 1740307321 | James L Eldersveld | Dentist | 4500 Cascade Rd Se, Suite 100, Grand Rapids, MI 49546-3665 | 2007-03-26 |
| 1013032010 | Mark Louis Salhaney | Dentist | 4500 Cascade Rd Se, Ste. 107, Grand Rapids, MI 49546-3665 | 2007-03-20 |
| 1124101712 | Mobile Anesthesiologists of Michigan Pllc | Anesthesiology | 4500 Cascade Rd Se, Grand Rapids, MI 49546-3665 | 2006-10-24 |
| 1568486769 | Kim L Erickson | Dentist | 4500 Cascade Rd Se, Suite #208, Grand Rapids, MI 49546-3665 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871982249 | Michigan Heart Lung and Vein Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2757 Leonard Ne, Ste 200, Grand Rapids, MI 49525-5807 | 2015-01-22 |
| 1679815898 | Hanna Park | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne Rm 8830, Grand Rapids, MI 49503 | 2013-03-26 |
| 1003060468 | Luis Alberto Tomatis | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Campau Cir Nw, Grand Rapids, MI 49503-2657 | 2008-11-12 |
| 1194796748 | Phillip Cabot Camp Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne Ste 8830, Grand Rapids, MI 49503-2560 | 2006-01-31 |
| 1215311220 | Giedrius Baliulis | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne, 10th Floor, Mc 248, Grand Rapids, MI 49503-2560 | 2015-07-20 |
| 1366859985 | Stephane Leung Wai Sang | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne, Suite 8830, Grand Rapids, MI 49503-2560 | 2014-07-15 |
| 1871933960 | Pulkesh Bhatia | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne Ste 8830, Grand Rapids, MI 49503-2560 | 2013-07-03 |
| 1154621605 | Spectrum Health Hospitals | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2010-11-01 |
| 1700908522 | Justin Shayne Fanning | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne, Suite 8830, Grand Rapids, MI 49503-2560 | 2007-04-04 |
| 1700914348 | David Jason Spurlock | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne, Suite 8830, Grand Rapids, MI 49503-2560 | 2007-03-02 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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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.