SPECTRUM HEALTH KENT COMMUNITY CAMPUS (NPI# 1740264522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740264522 |
| Entity Type | Organization |
| Organization Name | SPECTRUM HEALTH KENT COMMUNITY CAMPUS |
| Other Organization Name | SPECTRUM HEALTH REHAB & NURSING CENTER FULLER |
| Practice Address |
750 Fuller Ave Ne Grand Rapids MI 49503-1918 |
| Practice Telephone | 6163914200 |
| Practice Fax Number | 6164862419 |
| Mailing Telephone | 6163914200 |
| Mailing Fax Number | 6166439060 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2015-03-26 |
| Authorized Official Name | KEVIN SMITH (VP FINANCE) |
| Authorized Official Telephone | 6164862672 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 413090 | MI | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 413090 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 624151184 | 05 | |
| MI | BCBS | 09978 | 01 |
| Other Name | Type Code |
|---|---|
| Spectrum Health Rehab & Nursing Center Fuller | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548367964 | Spectrum Health Kent Community Campus | Durable Medical Equipment & Medical Supplies | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2006-09-20 |
| 1568440139 | Spectrum Health Kent Community Campus | General Acute Care Hospital | 750 Fuller Ave Ne, Mc 160, Grand Rapids, MI 49503 | 2006-01-04 |
| 1649255050 | Spectrum Health Kent Community Campus | General Acute Care Hospital | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2005-12-08 |
| Street Address |
750 FULLER AVE NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-1918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225012099 | Spectrum Health Continuing Care | Hospice Care, Community Based | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2005-12-05 |
| 1346744471 | Rachel Victoria Elery | Occupational Therapist | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2018-03-22 |
| 1063915940 | Page Breitfield | Occupational Therapist | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2018-03-16 |
| 1568965721 | Saurabh Bhalla | Physical Therapist | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2018-03-14 |
| 1184127631 | Randy G Meade | Occupational Therapist | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2018-03-12 |
| 1679076350 | Dana Smith | Occupational Therapist | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2018-03-09 |
| 1164924080 | Dawn Newell | Occupational Therapist | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2018-03-07 |
| 1689101784 | Spectrum Health Hospitals | Skilled Nursing Facility | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2017-05-19 |
| 1295127918 | Joann Crumm | Social Worker | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2015-03-04 |
| 1407011935 | Michigan Medical PC | Psychiatry & Neurology | 750 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | 2008-07-24 |
| 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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396975546 | Porter Hills Presbyterian Village, Inc. | Skilled Nursing Facility | 1029 E Paris Ave Se, Grand Rapids, MI 49546-3603 | 2009-07-22 |
| 1578739827 | St Ann's Home | Skilled Nursing Facility | 2161 Leonard Nw, Grand Rapids, MI 49504 | 2008-05-07 |
| 1922296730 | Lisa Ann Mervenne | Skilled Nursing Facility | 2520 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4696 | 2007-10-05 |
| 1730256207 | Welcov Healthcare LLC | Skilled Nursing Facility | 2801 S Highway 169, Grand Rapids, MN 55744-9552 | 2006-11-29 |
| 1992892525 | Trinity Continuing Care Services | Skilled Nursing Facility | 1050 4 Mile Rd Nw, Grand Rapids, MI 49544-1505 | 2006-10-06 |
| 1568554566 | Covenant Living of The Great Lakes | Skilled Nursing Facility | 2520 Lake Michigan Drive Nw, Grand Rapids, MI 49504-4696 | 2006-09-28 |
| 1235141151 | Cascade Care Center, Inc | Skilled Nursing Facility | 1095 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2006-08-12 |
| 1033137005 | Audrich, Inc. | Skilled Nursing Facility | 24201 3rd St, Grand Rapids, OH 43522-9785 | 2006-07-18 |
| 1205878998 | Heartland of Grand Rapids Mi LLC | Skilled Nursing Facility | 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906 | 2006-06-10 |
| 1184662793 | Itasca Nursing Home | Skilled Nursing Facility | 923 Hale Lake Pointe, Grand Rapids, MN 55744-9615 | 2006-06-04 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
Please comment or provide details below to improve the information on SPECTRUM HEALTH KENT COMMUNITY CAMPUS.
| 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.