NEPHROLOGY CONSULTANTS OF GRAND RAPIDS PC (NPI# 1528254877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528254877 |
Entity Type | Organization |
Organization Name | NEPHROLOGY CONSULTANTS OF GRAND RAPIDS PC |
Practice Address |
4070 Lake Dr Se Suite 201 Grand Rapids MI 49525 |
Mailing Address |
Po Box 150185 Grand Rapids MI 49515-0185 |
Practice Telephone | 6167748200 |
Practice Fax Number | 6167740304 |
Mailing Telephone | 6168662539 |
Mailing Fax Number | 6168663135 |
Enumeration Date | 2007-09-20 |
Last Update Date | 2008-09-26 |
Authorized Official Name | JESSICA SUE TUCK (MANAGER BILLING) |
Authorized Official Telephone | 6168662539 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
R0044045 | MI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 3371432 | 05 |
Street Address |
4070 LAKE DR SE SUITE 201 |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49525 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629054127 | Michael T Vollink | Optometrist | 4070 Lake Dr Se, Suite 101, Grand Rapids, MI 49546-8294 | 2005-12-16 |
1174974356 | Oculoplastic Associates of West Michigan, Plc | Ophthalmology | 4070 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8294 | 2016-06-28 |
1417365339 | Cynthia Geneva | Optometrist | 4070 Lake Dr Se, Suite 101, Grand Rapids, MI 49546-8294 | 2014-07-23 |
1376771717 | Advanced Urology of Grand Rapids | Urology | 4070 Lake Dr Se, Suite L101, Grand Rapids, MI 49546-8294 | 2009-06-24 |
1609018233 | Mark S Obrien Md Plc | Internal Medicine | 4070 Lake Dr Se, Suite 201, Grand Rapids, MI 49546-8294 | 2009-03-27 |
1164686812 | Tiffany Lauren Kent | Ophthalmology | 4070 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8294 | 2008-07-11 |
1295995629 | Physical Therapy Services of Grand Rapids, LLC | Clinic/Center | 4070 Lake Dr Se, Suite: 204, Grand Rapids, MI 49546-8294 | 2008-06-10 |
1457462467 | Richard Phillip Oconnor Jr. | Internal Medicine | 4070 Lake Dr Se, Ste 201, Grand Rapids, MI 49546-8294 | 2006-08-31 |
1972612919 | David E Thompson | Urology | 4070 Lake Dr Se, Ste 103, Grand Rapids, MI 49546-8294 | 2006-08-30 |
1356450290 | Michael Edward Novak | Urology | 4070 Lake Dr Se, Grand Rapids, MI 49546-8294 | 2006-08-30 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
Find all providers in zip 49525 |
Taxonomy Code | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154675825 | William Glenn Bouman | Internal Medicine | 1141 High Point Dr. Nw, Grand Rapids, MI 49544-7341 | 2012-11-02 |
1174898522 | Renal and Hypertension Specialists, Pllc | Internal Medicine | 4024 Park East Ct Se, Suite C, Grand Rapids, MI 49546-8810 | 2012-03-19 |
1306041520 | Brett William Plattner | Internal Medicine | 330 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49506-1267 | 2007-06-18 |
1295701209 | Ronald Michael Hofmann | Internal Medicine | 330 E Beltline Ave Ne, Suite 100, Grand Rapids, MI 49506-1267 | 2006-02-28 |
1457690125 | Paul A Delyria | Internal Medicine | 330 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49506-1267 | 2013-01-31 |
1093005373 | Ramandeep Singh Banga | Internal Medicine | 330 E Beltline Ave Ne, Suite 100, Grand Rapids, MI 49506-1267 | 2011-04-08 |
1295055572 | Bonita A. Mohamed | Internal Medicine | 330 E Beltline Ave Ne, Grand Rapids, MI 49506-1267 | 2010-06-09 |
1760678221 | Saurabh Kumar Goel | Internal Medicine | 330 E Beltline Ave Ne, Suite 100, Grand Rapids, MI 49506-1267 | 2007-09-19 |
1104036532 | Michael J Unruh | Internal Medicine | 330 E Beltline Ave Ne, Suite 100, Grand Rapids, MI 49506-1267 | 2007-05-23 |
1871674200 | Renal Associates of West Michigan PC | Internal Medicine | 330 E Beltline Ave Ne, Suite 100, Grand Rapids, MI 49506-1267 | 2006-10-19 |
Find all providers in GRAND RAPIDS |
City | GRAND RAPIDS |
Zip Code | 49525 |
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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.