WEST MICHIGAN CANCER CENTER (NPI# 1588778484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588778484 |
| Entity Type | Organization |
| Organization Name | WEST MICHIGAN CANCER CENTER |
| Other Organization Name | WEST MICHIGAN CANCER CENTER RADIATION ONCOLOGY |
| Practice Address |
200 N Park St Kalamazoo MI 49007-3731 |
| Mailing Address |
601 John St Box 42 Kalamazoo MI 49007-5341 |
| Practice Telephone | 2693822500 |
| Mailing Telephone | 2693417806 |
| Mailing Fax Number | 2693418743 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2011-11-30 |
| Authorized Official Name | DR. JOSEPH MIRRO (PRESIDENT/CEO/CMO) |
| Authorized Official Telephone | 2693822500 |
| Is Organization Subpart | Y |
| Parent Organization Name | WEST MICHIGAN CANCER CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBSM | 320C91143 | 01 | |
| BCBSM | 320C960590 | 01 | |
| UHC | 2430038 | 01 |
| Other Name | Type Code |
|---|---|
| West Michigan Cancer Center Radiation Oncology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730506510 | West Michigan Cancer Center | Pharmacy | 200 N Park St, Kalamazoo, MI 49007-3731 | 2014-03-18 |
| 1477640720 | West Michigan Cancer Center | Nurse Practitioner | 200 N Park St, Kalamazoo, MI 49007-3731 | 2006-10-06 |
| 1447261730 | West Michigan Cancer Center | Obstetrics & Gynecology | 200 N Park St, Kalamazoo, MI 49007-3731 | 2006-08-11 |
| Street Address |
200 N PARK ST |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49007-3731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051200 | Joseph Mirro Jr. | Pediatrics | 200 N Park St, West Michigan Cancer Center, Kalamazoo, MI 49007-3731 | 2005-05-24 |
| 1770105553 | Kathryn Barnett | Nurse Practitioner | 200 N Park St, Kalamazoo, MI 49007-3731 | 2020-05-14 |
| 1528618725 | Mallory Davis | Social Worker | 200 N Park St, Kalamazoo, MI 49007-3731 | 2019-09-19 |
| 1710498290 | Chelsea Ashcraft | Physician Assistant | 200 N Park St, Kalamazoo, MI 49007-3731 | 2017-10-24 |
| 1336650431 | Kaitlyn Mcgrail | Physician Assistant | 200 N Park St, Kalamazoo, MI 49007-3731 | 2017-10-16 |
| 1215394580 | Stephen Paul Rucker | Physician Assistant | 200 N Park St, Kalamazoo, MI 49007-3731 | 2016-01-18 |
| 1831566637 | Timothy Craig Nicaise Jr. | Nurse Practitioner | 200 N Park St, Kalamazoo, MI 49007-3731 | 2015-08-27 |
| 1730506510 | West Michigan Cancer Center | Pharmacy | 200 N Park St, Kalamazoo, MI 49007-3731 | 2014-03-18 |
| 1841624483 | Michael Thomas Francisco | Physician Assistant | 200 N Park St, Kalamazoo, MI 49007-3731 | 2013-08-31 |
| 1730463597 | Julie Ann Digiovanni | Clinical Nurse Specialist | 200 N Park St, Kalamazoo, MI 49007-3731 | 2011-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881248342 | Whitney Kiel | Pharmacist | 601 John Street Suite M-020, Kalamazoo, MI 49007 | 2019-08-01 |
| 1316591571 | Laura Jedele | Physical Therapist | Bronson Healthcare Group, 601 John St, Kalamazoo, MI 49007 | 2019-07-26 |
| 1992209084 | Yvonne Marie Heltzel | Behavior Technician | 1826 N Rose St, Kalamazoo, MI 49007 | 2018-03-22 |
| 1396263943 | Travis Todd Turrell | Physician Assistant | 125 S Kalamazoo Mall Suite 204, Kalamazoo, MI 49007 | 2017-09-05 |
| 1619493186 | Sarah Zuspann | Nurse Practitioner | 601 John Street, Suite 100, Kalamazoo, MI 49007 | 2017-08-16 |
| 1720529779 | Dannison | Psychologist | 604 S Rose St, Kalamazoo, MI 49007 | 2017-03-10 |
| 1265988901 | Calee Dieleman | Social Worker | 610 South Burdick, Kalamazoo, MI 49007 | 2016-09-01 |
| 1508313099 | Arriel Julia Ampey | Social Worker | 414 S. Burdick St., Suite 200, Kalamazoo, MI 49007 | 2016-09-01 |
| 1043662745 | Holloway Marston | Psychologist | 717 W South St, Apt. #6, Kalamazoo, MI 49007 | 2016-07-06 |
| 1205280062 | Bronson At Home | Home Health | 601 John St Ste M-431, Kalamazoo, MI 49007 | 2016-04-19 |
| Find all providers in zip 49007 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| 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 Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538489554 | Mazen Mislmani | Radiology | 200 N Park St, Kalamazoo, MI 49007-3731 | 2010-06-02 |
| 1750557047 | Jeffrey D Radawski | Radiology | 200 N Park St, Kalamazoo, MI 49007-3731 | 2008-05-06 |
| 1720287048 | Daniel Christopher Schroyer | Radiology | 200 N Park St, Kalamazoo, MI 49007-3731 | 2007-07-17 |
| 1548211360 | Linda D Grossheim | Radiology | 200 N Park St, West Michigan Cancer Center, Kalamazoo, MI 49007-5341 | 2006-05-15 |
| 1801881065 | Jacquelyn R Watson | Radiology | 200 N Park St, West Michigan Cancer Center, Kalamazoo, MI 49007-3731 | 2005-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1811444235 | Gwendolyn Henderson Parker | Radiology | 48165 Liberty Dr, Shelby Twp, MI 48315-4061 | 2016-09-01 |
| 1376097733 | Munson Medical Center | Radiology | 217 S Madison Avenue, Traverse City, MI 49684-2320 | 2016-08-15 |
| 1972985737 | Andrew Thompson | Radiology | 44378 Dequindre Rd Fl 1, Sterling Heights, MI 48314-1003 | 2015-06-29 |
| 1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
| 1932533692 | Compass Healthcare, Plc | Radiology | 2175 Coolidge Rd, East Lansing, MI 48823-1379 | 2013-08-29 |
| 1083903256 | Omar Hesham Gayar | Radiology | 4100 Beecher Rd Ste A, Flint, MI 48532-3661 | 2011-03-28 |
| 1881906519 | Sanath Kumar | Radiology | 18101 Oakwood Blvd Ste 411, Oakwood Hospital, Dearborn, MI 48124-4089 | 2010-07-10 |
| 1376772574 | Matthew W Packard | Radiology | 145 Michigan St Ne - Suite 2200, Lemmen-holton Cancer Pavilion (radiation/oncology), Grand Rapids, MI 49503 | 2009-07-08 |
| 1053575118 | North Macomb Mrt Center LLC | Radiology | 17900 23 Mile Road, Macomb Twp, MI 48042 | 2008-07-17 |
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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.