DR. ROGER W. EDVENSON (NPI# 1073531869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073531869 |
| Entity Type | Individual |
| Full Name | DR. ROGER W. EDVENSON |
| Credential | M.D. |
| Practice Address |
555 Midtowne Street Ne Suite 400 Grand Rapids MI 49503-5731 |
| Practice Telephone | 6165881200 |
| Practice Fax Number | 6165881250 |
| Mailing Telephone | 6165881200 |
| Mailing Fax Number | 6165881250 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2011-06-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 4301047210 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1627084 | 05 |
| Street Address |
555 MIDTOWNE STREET NE SUITE 400 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-5731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629066022 | Jane Brooke Thiel | Nurse Practitioner | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2005-10-10 |
| 1831303668 | Jamie Lynn Rodriguez | Nurse Practitioner | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2007-05-10 |
| 1265542153 | Rodman Murchison Taber | Obstetrics & Gynecology | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2006-08-30 |
| 1790895696 | Anita Dawn Vandeburg | Obstetrics & Gynecology | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2006-08-30 |
| 1548370455 | Ruth Anne Brandt | Obstetrics & Gynecology | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2006-08-30 |
| 1376557389 | Douglas M Vandrie | Obstetrics & Gynecology | 555 Midtowne Street Ne, Suite 450, Grand Rapids, MI 49503-5732 | 2006-07-27 |
| 1245258078 | Elizabeth J. Luce | Obstetrics & Gynecology | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2006-07-18 |
| 1164402012 | Sharla Marie Ulstad | Obstetrics & Gynecology | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503 | 2006-01-18 |
| 1063403657 | Robyn S Hubbard | Obstetrics & Gynecology | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2005-11-02 |
| 1871584466 | Jeffrey H Frank | Obstetrics & Gynecology | 555 Midtowne Street Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2005-11-02 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1265953335 | Jacqueline Cornell | Obstetrics & Gynecology | 300 Lafayette Ave Se Ste 3200, Grand Rapids, MI 49503-4692 | 2017-06-29 |
| 1689056244 | Stephanie Lynn Flermoen | Obstetrics & Gynecology | 3800 Lake Michigan Dr Nw Ste A, Grand Rapids, MI 49534-4583 | 2015-06-19 |
| 1770922064 | Emma Giuliani | Obstetrics & Gynecology | 3230 Eagle Park Dr Ne Ste 102, Grand Rapids, MI 49525-7047 | 2013-06-19 |
| 1861781783 | Maggi Ann Forgue | Obstetrics & Gynecology | 245 Cherry St Se Ste 306, Grand Rapids, MI 49503 | 2011-03-31 |
| 1043545882 | Mili Thakur | Obstetrics & Gynecology | 3230 Eagle Park Dr Ne Ste 100, Grand Rapids, MI 49525-7047 | 2009-10-13 |
| 1912105248 | Erinn Marie Hoekstra | Obstetrics & Gynecology | 555 Midtowne St. Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2007-07-09 |
| 1881891240 | Samuel Dean Fox | Obstetrics & Gynecology | 330 Barclay Ave Ne Ste 102, Grand Rapids, MI 49503-2525 | 2007-06-29 |
| 1558568204 | Knollcrestob-gyn Associates, P.C. | Obstetrics & Gynecology | 3300 Burton St Se, Grand Rapids, MI 49546-4398 | 2007-06-27 |
| 1134220270 | Joseph Peter Talcott | Obstetrics & Gynecology | 1525 E Beltline Ave Ne Ste 203, Grand Rapids, MI 49525-4598 | 2006-09-25 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49503 |
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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.