GRAND RAPIDS SURGICAL ASSOCIATES, PLLC (NPI# 1538521083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538521083 |
| Entity Type | Organization |
| Organization Name | GRAND RAPIDS SURGICAL ASSOCIATES, PLLC |
| Practice Address |
1009 44th St Sw Ste 101 Wyoming MI 49509-4480 |
| Practice Telephone | 6168284622 |
| Practice Fax Number | 6166352552 |
| Mailing Telephone | 6168284622 |
| Mailing Fax Number | 6166352552 |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-07-06 |
| Authorized Official Name | DR. KERENT DOMINIQUE PIHL (SURGEON/FOUNDER) |
| Authorized Official Telephone | 6166340936 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 5101019176 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
1009 44TH ST SW STE 101 |
| City | WYOMING |
| State | MI |
| Zip Code | 49509-4480 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619917572 | Karlin E Sevensma Do PC | Surgery | 1009 44th St Sw, Suite 101, Wyoming, MI 49509-4480 | 2006-06-08 |
| 1790283190 | Jennifer Ann Vanbeek | Marriage & Family Therapist | 1009 44th St Sw, Wyoming, MI 49509-4480 | 2018-01-31 |
| 1831550979 | Kayley Lafontaine | Psychologist | 1009 44th St Sw, Suite 103, Wyoming, MI 49509 | 2016-03-17 |
| 1689033037 | Jodine Cole Meyer | Psychologist | 1009 44th St Sw, Wyoming, MI 49509 | 2016-02-14 |
| 1619336070 | Nancy Baldus | Counselor | 1009 44th St Sw, Wyoming, MI 49509-4480 | 2016-02-14 |
| 1912366451 | Elizabeth Solan | Psychologist | 1009 44th St Sw, Suite 103b, Wyoming, MI 49509-4480 | 2016-02-11 |
| 1609292713 | Amanda Larson | Psychologist | 1009 44th St Sw, 103, Wyoming, MI 49509 | 2014-03-13 |
| 1902104029 | Kerent Dominique Pihl | Surgery | 1009 44th St Sw, Ste 101, Wyoming, MI 49509-4480 | 2011-03-14 |
| 1154441376 | Midwest Family Medicine PC | Family Medicine | 1009 44th St Sw, Suite A1, Wyoming, MI 49509-4480 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023620713 | Lindsay Kayann Ottowitz | Behavior Technician | 1428 44th St. Sw, Wyoming, MI 49509 | 2020-08-23 |
| 1750990016 | Lindsay Alexandra Lyszczarz | Behavior Technician | 5281 Clyde Park Ave Se, Suite 2, Wyoming, MI 49509 | 2020-07-23 |
| 1033690409 | Courtney M Garner | Behavior Technician | 1428 44th Street, Wyoming, MI 49509 | 2018-08-23 |
| 1457857195 | Ashley Mae Autio | Case Manager/Care Coordinator | 795 36th Street, Wyoming, MI 49509 | 2018-04-02 |
| 1689124588 | Jacqeulyn Harmon | Behavioral Analyst | 2819 Peckheath Rd Sw Apt D, Wyoming, MI 49509 | 2016-10-04 |
| 1275988925 | Intsar Abdulahe | Social Worker | 1551 Charles Russell, Wyoming, MI 49509 | 2016-05-02 |
| 1992160071 | Concierge Home Care Services of West Michigan, LLC | Home Infusion | 1360 56th Street Sw, Wyoming, MI 49509 | 2015-12-16 |
| 1417349796 | Yashana Duncan | Case Manager/Care Coordinator | 225 Colrain St. Sw, Suite 2, Wyoming, MI 49509 | 2015-02-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| 1366882755 | Kevin Timothy Solt | Dentist | 1535 44th St Sw Ste 200, Wyoming, MI 49509 | 2013-06-28 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619917572 | Karlin E Sevensma Do PC | Surgery | 1009 44th St Sw, Suite 101, Wyoming, MI 49509-4480 | 2006-06-08 |
| 1902887441 | Gregory W Johnson | Surgery | 2122 Health Dr Sw Ste 110, Wyoming, MI 49519-9698 | 2005-11-10 |
| 1821094129 | Wayne E Vanderkolk | Surgery | 1045 Gezon Pkwy Sw, Wyoming, MI 49509-9542 | 2005-06-22 |
| 1063907798 | Ann Jean Debartolo | Surgery | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2018-06-26 |
| 1982198115 | William Morgan | Surgery | 5900 Byron Center Ave Sw, Wyoming, MI 49519 | 2018-06-20 |
| 1548780844 | Mandalyn J Kautz | Surgery | 5900 Byron Center Ave Sw, Wyoming, MI 49519 | 2017-06-27 |
| 1366962128 | Emily Mckerchie | Surgery | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2017-06-22 |
| 1992156780 | Jamie Lynn Benedek Serrano | Surgery | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2016-06-23 |
| 1457702243 | Rebecca Douglass | Surgery | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2016-06-23 |
| 1154703577 | Miranda Allen | Surgery | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2015-06-22 |
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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.