HEALTHSTAT- JEDCO


Address: 1615 Broadway Ave Nw, Grand Rapids, MI 49504-2026
Phone: 6164595161

HEALTHSTAT- JEDCO (NPI# 1609129303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609129303
Entity Type Organization
Organization Name HEALTHSTAT- JEDCO
Practice Address 1615 Broadway Ave Nw
Grand Rapids
MI 49504-2026
Mailing Address 4651 Charlotte Park Dr
Suite 300
Charlotte
NC 28217-1956
Practice Telephone 6164595161
Enumeration Date 2012-10-18
Last Update Date 2012-10-18
Authorized Official Name WARREN HUTTON (COO)
Authorized Official Telephone 7045296161
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2083P0500X Preventive Medicine
Specialization: Preventive Medicine/Occupational Environmental Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 1615 BROADWAY AVE NW
City GRAND RAPIDS
State MI
Zip Code 49504-2026

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477049518 Mark Contreras Nurse Practitioner 72 Sheldon Blvd Se # 130, Grand Rapids, MI 49504 2018-07-02
1205338753 Kelli Marie Selby Physical Therapist 235 Wealthy, Grand Rapids, MI 49504 2018-03-01
1871094474 Kymiri Lyn Coles Physical Therapist 1000 Edison Ave Ne, Grand Rapids, MI 49504 2018-02-28
1881132744 Courtney Glinka Behavior Technician 1149 Butterworth St Sw, Grand Rapids, MI 49504 2017-02-10
1649650300 Alyson Renee Vela Social Worker 1256 Walker Ave Ne, Grand Rapids, MI 49504 2015-06-08
1508258500 Grand Rapids Natural Health Nutritionist 638 Fulton Street W., Grand Rapids, MI 49504 2015-02-27
1144622598 Robert Mclaren Physical Therapist 2807 Lake Michigan Dr Nw Ste 1, Grand Rapids, MI 49504 2014-09-17
1972854339 Beth Ellen Gregory Registered Nurse 1956 Walker Avenue Northwest, Grand Rapids, MI 49504 2012-09-26
1588914147 Unlimited Alternatives Community/Behavioral Health 282 Leonard, Grand Rapids, MI 49504 2012-09-11
1386912178 Michael Allen Crawford Pharmacist 800 West Leonard Nw, Grand Rapids, MI 49504 2011-12-07
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Taxonomy Information

Taxonomy Code 2083P0500X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Preventive Medicine/Occupational Environmental Medicine

Taxonomy Definition

A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1538766639 Corporate Occupational Health PC Preventive Medicine 3501 Lake Eastbrook Blvd Se Ste 144, Grand Rapids, MI 49546-5939 2020-10-02
1205974052 Bradley Neal Friedland Preventive Medicine 2428 Lake Dr Se, Grand Rapids, MI 49506-3162 2007-02-02
1770522401 Robert John Kantor Preventive Medicine 1620 44th St Se, Grand Rapids, MI 49508-5002 2006-06-06
1477601847 Richard Alexsander Ilka Preventive Medicine 1000 E Paris Ave Se, 218, Grand Rapids, MI 49546-3691 2007-01-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1770194375 Healthstat Inc Huhtamaki-michigan Preventive Medicine 5700 W Shaffer Rd, Coleman, MI 48618-9706 2020-08-17
1487265088 Healthstat Inc National Gypsum-national City Preventive Medicine 2375 S National City Rd, National City, MI 48748-9623 2020-08-17
1619494762 Healthstat Onsite Clinic Keihin Capac Preventive Medicine 14898 Koehn Rd, Mussey, MI 48014-4310 2017-08-29
1174944953 Healthstat On-site Clinic/unified Michigan Preventive Medicine 520 S. Coldwater Rd., Weidman, MI 48893 2013-12-23
1598018152 Healthstat- Carson City Hospital Preventive Medicine 46 Elm St., Carson City, MI 48811 2012-10-19
1083905541 Rosalind Marie Cohen Preventive Medicine 1106 E Cook Rd, Grand Blanc, MI 48439-8368 2011-05-02
1629307251 Michigan State University Preventive Medicine 346 Olin Health Ctr, East Circle Drive, East Lansing, MI 48824-1037 2009-12-10
1649421108 Reynolds B Brissenden IIi Preventive Medicine 409 Timberlake Dr W, Holland, MI 49424-5338 2008-10-02
1992903371 Gary Richard Kerstein Preventive Medicine 1800 Hickory Valley Rd, Milford, MI 48380-4276 2007-07-06
1396949509 Alicia E Alimboyoguen Preventive Medicine 1300 N Dort Hwy, Mc 485-202-100, Flint, MI 48556-0001 2007-06-12
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Competitor

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City GRAND RAPIDS
Zip Code 49504

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Dataset Information

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.

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