SPECTRUM HEALTH PRIMARY CARE PARTNERS (NPI# 1417266685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417266685 |
| Entity Type | Organization |
| Organization Name | SPECTRUM HEALTH PRIMARY CARE PARTNERS |
| Practice Address |
2902 Bradford St Ne Grand Rapids MI 49525-6427 |
| Mailing Address |
100 Michigan St Ne Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6164866577 |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2011-10-14 |
| Authorized Official Name | PAULINE KRYWANSKI (SVP) |
| Authorized Official Telephone | 6164862253 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPECTRUM HEALTH PRIMARY CARE PARTNERS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| 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 |
2902 BRADFORD ST NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-6427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942289798 | Michael G Dickinson | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525 | 2006-01-11 |
| 1639445844 | Matthew Hans Gonzalez | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2012-04-02 |
| 1356643027 | Spectrum Health Hospitals | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2010-12-01 |
| 1942523261 | Susan Marie Dalrymple | Nurse Practitioner | 2902 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2010-03-02 |
| 1306099973 | Jacquelyn May Oliai | Nurse Practitioner | 2902 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2008-10-28 |
| 1598914228 | Laura Borst Braunohler | Nurse Practitioner | 2902 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2008-09-18 |
| 1447411004 | Milena Jani | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525 | 2008-06-17 |
| 1447442215 | David Robert Fermin | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525 | 2007-08-15 |
| 1275742389 | Renzo Ygor Loyaga-rendon | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2007-05-22 |
| 1841415098 | Ryan Grayburn | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2007-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073836250 | Raymond Everett Fuller | Internal Medicine | 15 Andre St Se, Grand Rapids, MI 49507-3010 | 2010-03-02 |
| 1447299599 | Ronald Vanderlaan | Internal Medicine | 1310 E Beltline Ave Se, Ste 130, Grand Rapids, MI 49506-4303 | 2006-06-05 |
| 1942289798 | Michael G Dickinson | Internal Medicine | 2902 Bradford St Ne, Grand Rapids, MI 49525 | 2006-01-11 |
| 1952382137 | David Bryan Johnson | Internal Medicine | 638 Fulton St W, Suite B, Grand Rapids, MI 49504-6313 | 2005-11-07 |
| 1265423651 | Prerana Anand Manohar | Internal Medicine | 5043 Cascade Rd Se, Grand Rapids, MI 49546-3724 | 2005-11-03 |
| 1669984480 | Advanced Cardiac & Vascular Centers for Amputation Prevention Plc | Internal Medicine | 1525 E Beltline Ave Ne, Grand Rapids, MI 49525-4598 | 2017-11-02 |
| 1114389251 | Christopher Madison | Internal Medicine | 2900 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2016-03-28 |
| 1366804940 | Malav Parikh | Internal Medicine | 2900 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2016-03-23 |
| 1265849541 | Jose Mariano Tiu Tan II | Internal Medicine | 2900 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2014-07-17 |
| 1871919290 | Spectrum Health Primary Care Partners | Internal Medicine | 2900 Bradford St Ne, Grand Rapids, MI 49525-6427 | 2014-03-10 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
Please comment or provide details below to improve the information on SPECTRUM HEALTH PRIMARY CARE PARTNERS.
| 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.