SOURCE MEDICAL SOLUTIONS PLLC (NPI# 1326649120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326649120 |
| Entity Type | Organization |
| Organization Name | SOURCE MEDICAL SOLUTIONS PLLC |
| Practice Address |
625 Kenmoor Ave Se Ste 301 Grand Rapids MI 49546-2395 |
| Practice Telephone | 5132331511 |
| Mailing Telephone | 5132331511 |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |
| Authorized Official Name | DR. THOMAS HENKE (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 5132331511 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
625 KENMOOR AVE SE STE 301 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-2395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023406188 | Elite Health, Plc | General Practice | 310 Fulton St E, Suite A, Grand Rapids, MI 49503-4302 | 2014-12-24 |
| 1275712887 | Dr. Rafael Torres PC | General Practice | 6460 28th St Se, Grand Rapids, MI 49546-6918 | 2007-10-31 |
| 1497967947 | William A Wagner | General Practice | 2317 Elmwood Dr Se, Grand Rapids, MI 49506-4055 | 2007-05-05 |
| 1952479503 | Emergency Physicians Inc PC | General Practice | 324 Forest Hill Ave Se, Grand Rapids, MI 49546-2316 | 2006-12-01 |
| 1124123476 | Lourens J Willekes | General Practice | 751 Lafeyette Nw, Grand Rapids, MI 49503 | 2006-09-13 |
| 1568401032 | Sheila Marie Vanlowe-prince | General Practice | 847 Parchment Dr Se Ste 120, Grand Rapids, MI 49546-2377 | 2006-06-06 |
| 1114920550 | Emergency Physicians Inc PC | General Practice | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2005-05-31 |
| 1306235569 | Kelsey Sturgis | General Practice | 743 E Beltline Ave Ne, Grand Rapids, MI 49525-6045 | 2015-01-12 |
| 1619147493 | Joanne Marie Grzeszak Do PC | General Practice | 806 Alger St Se, Grand Rapids, MI 49507-3803 | 2008-03-07 |
| 1164611836 | Gary W Bailey Do PC | General Practice | 2525 Burton St Se, Grand Rapids, MI 49546 | 2007-10-18 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on SOURCE MEDICAL SOLUTIONS PLLC.
| 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.