PENNANT PHYSICIAN SERVICES (NPI# 1245572007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245572007 |
| Entity Type | Organization |
| Organization Name | PENNANT PHYSICIAN SERVICES |
| Practice Address |
555 Midtowne St Ne Suite 310 Grand Rapids MI 49503-5729 |
| Mailing Address |
2122 Health Dr Sw Suite 230 Wyoming MI 49519-9698 |
| Practice Telephone | 6162524765 |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |
| Authorized Official Name | FRANK E BELSITO (CMO) |
| Authorized Official Telephone | 6162525211 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians |
| Street Address |
555 MIDTOWNE ST NE SUITE 310 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49503-5729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235133992 | Michelle A Klyn | Obstetrics & Gynecology | 555 Midtowne St Ne, Ste 450, Grand Rapids, MI 49503 | 2005-06-10 |
| 1154761773 | Orthopaedic Associates of Grand Rapids, PC | Orthopaedic Surgery | 555 Midtowne St Ne, Suite 105, Grand Rapids, MI 49503-5729 | 2013-06-27 |
| 1467798231 | Roxanne Kay Cornelius | Physician Assistant | 555 Midtowne St Ne, Suite 110, Grand Rapids, MI 49503-5729 | 2012-12-21 |
| 1780933432 | Dermatology At Midtowne, PC | Dermatology | 555 Midtowne St Ne, Suite 301, Grand Rapids, MI 49503-5729 | 2012-09-09 |
| 1912265521 | Amy Marie Strikwerda | Dermatology | 555 Midtowne St Ne, Suite 301, Grand Rapids, MI 49503-5729 | 2012-05-02 |
| 1720390511 | Heather Jereb | Obstetrics & Gynecology | 555 Midtowne St Ne, Suite 400, Grand Rapids, MI 49503-5731 | 2010-07-08 |
| 1235441262 | Spectrum Health Primary Care Partners | Obstetrics & Gynecology | 555 Midtowne St Ne, Suite 302, Grand Rapids, MI 49503-5729 | 2010-07-07 |
| 1013234707 | Bradley Bengtson, M.d. PC | Plastic Surgery | 555 Midtowne St Ne, Suite 110, Grand Rapids, MI 49503-5729 | 2010-04-21 |
| 1700102993 | Midtowne Pharmacy | Pharmacy | 555 Midtowne St Ne, Suite 103, Grand Rapids, MI 49503-5729 | 2010-04-13 |
| 1952539603 | Kory James Johnson | Orthopaedic Surgery | 555 Midtowne St Ne, Suite 105, Grand Rapids, MI 49503-5729 | 2009-07-01 |
| 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 | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013903947 | Linda Barbara Pauliks | Pediatrics | 25 Michigan St Ne Ste 4200, Grand Rapids, MI 49503-2559 | 2005-09-26 |
| 1639175342 | Stephen Christopher Cook | Pediatrics | 25 Michigan St Ne, Suite 4300, Grand Rapids, MI 49503 | 2005-06-27 |
| 1467734442 | Emy Mary Kuriakose | Pediatrics | 25 Michigan St Ne, Suite 4300, Grand Rapids, MI 49503 | 2011-09-15 |
| 1306163092 | Stanley Charles Sedore | Pediatrics | 25 Michigan St Ne Ste 4200, Grand Rapids, MI 49503-2559 | 2010-04-21 |
| 1700036274 | Heather Aileen Sowinski | Pediatrics | 25 Michigan St Ne, Suite 4300, Grand Rapids, MI 49503 | 2008-09-22 |
| 1700058492 | Michigan Medical Patient Care | Pediatrics | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2008-04-02 |
| 1861587602 | Kim J. Lee | Pediatrics | 25 Michigan St Ne, Suite 4300, Grand Rapids, MI 49503 | 2006-10-04 |
| 1447345285 | Michael S Florentine | Pediatrics | 100 Michigan St Ne, 10th Floor, Grand Rapids, MI 49503-2560 | 2006-10-04 |
| 1366537177 | Jeffrey R Schneider | Pediatrics | 25 Michigan St Ne, Suite 4300, Grand Rapids, MI 49503 | 2006-10-04 |
| 1811091168 | Samuel J Lacina | Pediatrics | 25 Michigan St Ne, Suite 4300, Grand Rapids, MI 49503 | 2006-09-08 |
| 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.