MALLORY MARTENS (NPI# 1629433172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629433172 |
Entity Type | Individual |
Full Name | MALLORY MARTENS |
Credential | PA |
Practice Address |
100 Michigan St Ne Grand Rapids MI 49503 |
Mailing Address |
100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 |
Practice Telephone | 6163913431 |
Practice Fax Number | 6163912783 |
Enumeration Date | 2015-12-29 |
Last Update Date | 2016-02-29 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601007638 | MI | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
100 MICHIGAN ST NE |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49503 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922001668 | Surender Rajasekaran | Anesthesiology | 100 Michigan St Ne, Mc 117, Grand Rapids, MI 49503-2560 | 2005-05-26 |
1710587415 | Mara S Brown | Registered Nurse | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-10-30 |
1033718044 | Anh Thi Mai Huynh | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-10-21 |
1427687201 | Kayla Renee Smith | Student in an Organized Health Care Education/Training Program | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-04-03 |
1407487424 | Jessica B Doorn | Dietitian, Registered | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-01-29 |
1649810391 | Olivia Lauren Presnell | Physician Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2020-01-10 |
1316586381 | Keith Minbiole | Anesthesiologist Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-23 |
1427697499 | Alexander Linkner | Anesthesiologist Assistant | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-23 |
1619514593 | Louise Mcwhirter | Anesthesiology | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-10 |
1316584915 | Professional Treatment Solutions PC | Anesthesiology | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-12-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801496195 | Airway Oxygen, Inc. | Durable Medical Equipment & Medical Supplies | Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 | 2020-10-27 |
1730707282 | Adriana Molina-schmuker | Counselor | 901 Eastern Avenue Ne, Grand Rapids, MI 49503 | 2020-07-10 |
1477176949 | Kimberly Buskirk | Specialist | 1131 Ionia Ava Nw, Grand Rapids, MI 49503 | 2020-05-19 |
1124647805 | Jared Host | Speech-Language Pathologist | Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 | 2020-04-13 |
1265061378 | Heather Gladfelter | Student in an Organized Health Care Education/Training Program | 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 | 2020-04-02 |
1194368647 | Amy Jo Arends | Nurse Practitioner | 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 | 2019-10-28 |
1376185199 | Beth Arce | Occupational Therapist | 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 | 2019-10-14 |
1295387256 | Althea Ziolkowski | Licensed Practical Nurse | Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 | 2019-07-10 |
1790340719 | Heather Anne Fox | Occupational Therapist | Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 | 2019-05-06 |
1184182883 | April L Kaiserlian | Social Worker | 983 Spaulding Ave Ne, Ada, MI 49503 | 2019-03-12 |
Find all providers in zip 49503 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740839505 | Rachel Lauren Zokoe | Physician Assistant | 4024 Park East Ct Se Ste C, Grand Rapids, MI 49546-8810 | 2019-09-05 |
1689046187 | Emily Lauren Amato | Physician Assistant | 1310 E Beltline Ave Se Ste 130, Grand Rapids, MI 49506-4303 | 2015-10-22 |
1568864353 | Brittany L Babiak | Physician Assistant | 4362 Cascade Rd Se Ste 206, Grand Rapids, MI 49546-3670 | 2014-09-23 |
1760760037 | Cristian Rodriguez | Physician Assistant | 2155 Buchanan St Sw, Grand Rapids, MI 49507 | 2011-08-03 |
1851423750 | Barbara Ann Grinwis | Physician Assistant | 522 Leonard St Nw, Grand Rapids, MI 49504-4258 | 2007-03-09 |
1922170158 | Robin M Iknayan | Physician Assistant | 350 Lafayette Ave Se Fl 4, Grand Rapids, MI 49503-4656 | 2006-11-14 |
1043391154 | Marc Allen Bush | Physician Assistant | 100 Michigan St. Nw, Suite A721, Grand Rapids, MI 49503 | 2006-10-17 |
1437254430 | David Joseph Barney | Physician Assistant | 6690 Crossings Dr Se Ste C, Grand Rapids, MI 49508 | 2006-09-14 |
1144232505 | Robert W Schmitt | Physician Assistant | 3260 Eagle Park Dr Ne Ste 115, Grand Rapids, MI 49525-4569 | 2006-08-13 |
1598775322 | Crystal A Dole | Physician Assistant | 2155 E Paris Ave Se Ste 210, Grand Rapids, MI 49546-6142 | 2006-08-08 |
Find all providers in GRAND RAPIDS |
City | GRAND RAPIDS |
Zip Code | 49503 |
Please comment or provide details below to improve the information on MALLORY MARTENS.
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.