SPECTRUM HEALTH HOSPITALS (NPI# 1528300738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528300738 |
| Entity Type | Organization |
| Organization Name | SPECTRUM HEALTH HOSPITALS |
| Practice Address |
6105 Wilson Ave Sw Wyoming MI 49418-9714 |
| Mailing Address |
100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6164865100 |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-08-23 |
| Authorized Official Name | PAULINE KRYWANSKI (SVP, FINANCE) |
| Authorized Official Telephone | 6164862253 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPECTRUM HEALTH HOSPITALS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MI | Allopathic & Osteopathic Physicians | |
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407313802 | Spectrum Health Hospitals | Clinic/Center | 4069 Lake Dr Se Ste 210, Grand Rapids, MI 49546-8816 | 2019-02-22 |
| 1306208244 | Spectrum Health Hospitals | Pediatrics | 217 S Madison, Traverse City, MI 49684 | 2016-03-21 |
| 1922440478 | Spectrum Health Hospitals | Preventive Medicine | 1208 W Oak St, Greenville, MI 48838-2155 | 2013-07-25 |
| 1164665709 | Spectrum Health Hospitals | Durable Medical Equipment & Medical Supplies | 2902 Bradford St. Ne, Grand Rapids, MI 49525-6427 | 2009-04-13 |
| 1114014594 | Spectrum Health Hospitals | Durable Medical Equipment & Medical Supplies | 4100 Lake Drive Se, Suite 100, Grand Rapids, MI 49546-8292 | 2006-10-06 |
| 1447358304 | Spectrum Health Hospitals | Durable Medical Equipment & Medical Supplies | 5378 Plainfield Ave Ne, Grand Rapids, MI 49525-1053 | 2006-09-21 |
| 1255347068 | Spectrum Health Hospitals | Clinic/Center | 973 Ottawa Ave Nw, Attn: Pat Poling, Grand Rapids, MI 49503-1431 | 2006-08-01 |
| 1275529562 | Spectrum Health Hospitals | Clinic/Center | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2005-09-22 |
| 1366438632 | Spectrum Health Hospitals | Clinic/Center | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2005-09-22 |
| 1962494120 | Spectrum Health Hospitals | Clinic/Center | 35 Michigan St Ne, Grand Rapids, MI 49503-2514 | 2005-08-15 |
| Street Address |
6105 WILSON AVE SW |
| City | WYOMING |
| State | MI |
| Zip Code | 49418-9714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427052265 | David R. Heyboer | Internal Medicine | 6105 Wilson Ave Sw, Suite 202, Wyoming, MI 49418 | 2005-06-09 |
| 1679076533 | Melissa L Mccormick | Physical Therapist | 6105 Wilson Ave Sw, Wyoming, MI 49418-9714 | 2018-03-16 |
| 1982106670 | Amanda Rose Travis | Physical Therapist | 6105 Wilson Ave Sw, Wyoming, MI 49418-9714 | 2018-03-08 |
| 1568964377 | Kathleen Sue Knopf Simpson | Physical Therapist | 6105 Wilson Ave Sw, Wyoming, MI 49418-9714 | 2018-03-07 |
| 1730524398 | West Michigan Heart | Internal Medicine | 6105 Wilson Ave Sw, Wyoming, MI 49418-9714 | 2013-05-08 |
| 1629310826 | Spectrum Health Primary Care Partners | Emergency Medicine | 6105 Wilson Ave Sw, Wyoming, MI 49418-9714 | 2013-03-26 |
| 1205174604 | Matthew Brower | Physician Assistant | 6105 Wilson Ave Sw, Suite 101, Wyoming, MI 49418-9714 | 2013-01-21 |
| 1528370541 | Spectrum Health Primary Care Partners | Internal Medicine | 6105 Wilson Ave Sw, Suite 202, Wyoming, MI 49418-9714 | 2010-07-07 |
| 1891995536 | Laura M Franey | Internal Medicine | 6105 Wilson Ave Sw, Suite 101, Wyoming, MI 49418-9714 | 2007-07-20 |
| 1306968763 | Ryan D Madder | Internal Medicine | 6105 Wilson Ave Sw, Suite 101, Wyoming, MI 49418-9714 | 2007-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144799669 | Holly Cieslinski | Occupational Therapist | 3550 Fairlines Ave, Grandville, MI 49418 | 2018-11-14 |
| 1639664857 | Athletico Ltd | Physical Therapist | 3819 Rivertown Pkwy Sw Ste 100, Grandville, MI 49418 | 2018-06-29 |
| 1437651916 | Great Lakes Wellness Counseling LLC | Counselor | 2900 Wilson Ave Suite 110, Grandville, MI 49418 | 2018-03-01 |
| 1780111765 | Jenna Sargent | Nurse Practitioner | 2845 44th St Sw, Ste 200, Grandville, MI 49418 | 2017-05-22 |
| 1881132827 | Laura Elizabeth Ramaker | Specialist/Technologist | 2787 Pine Dunes Ct Sw, Wyoming, MI 49418 | 2017-02-10 |
| 1689026130 | Charles Unseld | Hearing Instrument Specialist | O-38 44th St Sw, Grandville, MI 49418 | 2016-07-08 |
| 1972989655 | Laci Dawn Johncock | Physical Therapy Assistant | 2786 56th Street, Wyoming, MI 49418 | 2015-08-05 |
| 1891178570 | Joshua Kolman | Pharmacist | 3434 Century Center Dr Sw, Grandville, MI 49418 | 2015-06-30 |
| 1710368782 | Tracie Medrano- Smith | Family Medicine | 4174 56th St Sw, Wyoming, MI 49418 | 2015-06-15 |
| 1124410808 | Kim Michelle Childress | Counselor | 4565 Wilson Ave Sw Ste 3a, Grandville, MI 49418 | 2015-03-04 |
| Find all providers in zip 49418 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1720425788 | David Martin Cameron | Internal Medicine | 6105 Wilson Ave Sw Ste 101, Wyoming, MI 49418-9714 | 2013-05-31 |
| 1497072243 | Ammar Zahid Hassan | Internal Medicine | 2093 Health Dr Sw Ste 302, Wyoming, MI 49519 | 2010-05-03 |
| 1720097231 | David C Tabor | Internal Medicine | 2093 Health Dr, Suite 201, Wyoming, MI 49519 | 2006-08-05 |
| 1164443578 | Tandy Champion | Internal Medicine | 4166 56th St Sw, Wyoming, MI 49418-9352 | 2006-07-21 |
| 1790749042 | Michael C Mccully | Internal Medicine | 2093 Health Drive Sw, Suite 302, Wyoming, MI 49519 | 2006-04-13 |
| 1487617684 | Fariba Modares | Internal Medicine | 389 Wyoming Ave, Wyoming, PA 18644-1821 | 2006-04-10 |
| 1275537011 | Thomas V Bilisko | Internal Medicine | 2093 Health Dr Sw, Ste 200, Wyoming, MI 49519-9691 | 2005-06-09 |
| 1427052265 | David R. Heyboer | Internal Medicine | 6105 Wilson Ave Sw, Suite 202, Wyoming, MI 49418 | 2005-06-09 |
| 1760484869 | Anita Irene Charochak | Internal Medicine | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2005-06-02 |
| 1972098614 | Jeffrey Ray Williams | Internal Medicine | 5900 Byron Center Ave Sw, Wyoming, MI 49519 | 2018-06-26 |
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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.