CORWYN B BERGSMA (NPI# 1447281662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447281662 |
| Entity Type | Individual |
| Full Name | CORWYN B BERGSMA |
| Credential | D.P.M. |
| Practice Address |
1195 Wilson Ave Nw Suite 200 Grand Rapids MI 49534-6405 |
| Mailing Address |
4540 Kalamazoo Ave Se Kentwood MI 49508-4625 |
| Practice Telephone | 6164538277 |
| Practice Fax Number | 6164532002 |
| Mailing Telephone | 6162810666 |
| Mailing Fax Number | 6162810752 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
5901002157 | MI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4584211 | 05 | |
| MI | RAILROAD MEDICARE | 480026386 | 01 |
| MI | ADMINISTAR | 1266510001 | 01 |
| Street Address |
1195 WILSON AVE NW SUITE 200 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49534-6405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639341365 | Joshua Robert Decker | Podiatrist | 1195 Wilson Ave Nw, Grand Rapids, MI 49534-3493 | 2008-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336792324 | Heather Duthler | Social Worker | 648 Kinney Ave Nw, Grand Rapids, MI 49534 | 2019-07-19 |
| 1114473550 | Tari Kruzel | Registered Nurse | 12955 3rd Ave Nw, Grand Rapids, MI 49534 | 2016-08-26 |
| 1972847184 | Indian Trails Camp, Inc. | Day Training, Developmentally Disabled Services | O-1859 Lake Michigan Dr. Nw, Grand Rapids, MI 49534 | 2012-11-15 |
| 1871743815 | Michael Robert Anderson Jr. | Chiropractor | 0-705 Tallmadge Woods Dr. Nw, Suite A, Grand Rapids, MI 49534 | 2008-09-26 |
| 1750459285 | Rick David Saier | Internal Medicine | 1175 Wilson Ave, Walker, MI 49534 | 2006-12-01 |
| 1154414886 | Edward D Young Dds PC | Dentist | 4310 Leonard Nw, Grand Rapids, MI 49534 | 2006-10-02 |
| 1558461756 | Sandra Staublin | Pediatrics | 4288 3 Mile Road, Walker, MI 49534 | 2006-09-25 |
| 1700986999 | Belinda Chou | Pediatrics | 4288 Three Mile Road, Walker, MI 49534 | 2006-09-25 |
| 1639196603 | David Robert Felton | Chiropractor | 4110 Lake Michigan Dr Nw, Grand Rapids, MI 49534 | 2006-07-16 |
| 1952349235 | Chiropractic Plus, P.C. | Chiropractor | 0 699 Tallmadge Wds Nw, Suite B, Grand Rapids, MI 49534 | 2006-06-02 |
| Find all providers in zip 49534 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912318502 | Brianna M David | Podiatrist | 2144 E Paris Ave Se Ste 100, Grand Rapids, MI 49546-6117 | 2014-05-16 |
| 1154460962 | Foot & Ankle Specialists of West Michigan P L L C | Podiatrist | 2144 E Paris Se, Ste 100, Grand Rapids, MI 49546 | 2007-02-06 |
| 1679591226 | Eric K Gilbertson | Podiatrist | 1542 Golf Course Rd Ste 208, Grand Rapids, MN 55744-3555 | 2006-07-18 |
| 1790714277 | Michael George David | Podiatrist | 2144 East Paris Ave Se, Ste 100, Grand Rapids, MI 49546 | 2006-06-30 |
| 1679501290 | Patrick J Meyer | Podiatrist | 5175 Plainfield Drive N.e., Grand Rapids, MI 49525 | 2006-06-30 |
| 1023046844 | William Robert Decker | Podiatrist | 1195 Wilson Nw, Grand Rapids, MI 49534-6404 | 2006-06-29 |
| 1528094257 | Richard W Rozelle | Podiatrist | 5175 Plainfield Ave Ne, Grand Rapids, MI 49525-1048 | 2006-06-24 |
| 1023053436 | Timothy J Hulst | Podiatrist | 2144 E. Paris Ave. Se, Ste 100, Grand Rapids, MI 49546 | 2006-06-19 |
| 1598760001 | Stephen D Harris | Podiatrist | 3260 Eagle Park Dr Ne, Suite 116, Grand Rapids, MI 49525-4569 | 2005-06-21 |
| 1821633967 | Renew Foot & Ankle LLC | Podiatrist | 1542 Golf Course Rd Ste 208, Grand Rapids, MN 55744-3555 | 2019-11-13 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49534 |
Please comment or provide details below to improve the information on CORWYN B BERGSMA.
| 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.