KARA ANNE WILLOUGHBY (NPI# 1720468622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720468622 |
| Entity Type | Individual |
| Full Name | KARA ANNE WILLOUGHBY |
| Other Name | KARA ANNE WACKERLE |
| Credential | MD |
| Practice Address |
1545 68th St Se Ste 100 Grand Rapids MI 49508 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6162677881 |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2018-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301114490 | MI | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MT208825 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
1545 68TH ST SE STE 100 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669807970 | Lisa Ann Watkins | Nurse Practitioner | 1545 68th St Se Ste 100, Grand Rapids, MI 49508-7896 | 2013-09-05 |
| 1134673361 | Beth Ellen Shepherd | Social Worker | 1545 68th St Se Ste 100, Grand Rapids, MI 49508-7896 | 2016-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012367 | Jenna Brianne Labrecque | Social Worker | 2013 East Castle Dr, Suite B, Kentwood, MI 49508 | 2020-10-27 |
| 1881208809 | Morgan Paige Ballmann | Physical Therapy Assistant | 4150 Kalamazoo Ave. Se, Grand Rapids, MI 49508 | 2020-09-08 |
| 1699385740 | Jodie Lynn Robertson | Prosthetist | 3720 Eastern Se, Grand Rapids, MI 49508 | 2020-08-04 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1255801833 | Ikeia Tynika Hill | Licensed Practical Nurse | 1627 Lotus, Grand Rapids, MI 49508 | 2018-11-27 |
| 1326556838 | Araceli Contreras-hernandez | Behavior Technician | 3566 Eastern Ave. Se, Kentwood, MI 49508 | 2018-01-18 |
| 1881102788 | A Grand Rapids Senior Social Exchange and Adult Day Center | In Home Supportive Care | 3212 Eastern Ave Se, Grand Rapids, MI 49508 | 2018-01-14 |
| 1952827107 | Nupoint Services LLC | Clinic/Center | 1620 44th Street Se, Grand Rapids, MI 49508 | 2017-08-19 |
| 1710427695 | Embracing Life Afc | Custodial Care Facility | 1405 Forrester St S.e., Grand Rapids, MI 49508 | 2017-02-27 |
| 1083162838 | Katherine Berenice Campoverde Arevalo | Technician, Other | 1157 Billigs Ct Se, Ap# 1a, Grand Rapids, MI 49508 | 2016-09-21 |
| Find all providers in zip 49508 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912427402 | Stephen Gunnink | Pediatrics | 100 Michigan St. Se, Grand Rapids, MI 49503-2527 | 2017-06-26 |
| 1003336595 | Cory Minier Schmidt | Pediatrics | 330 Barclay Ave Ne Ste 330, Grand Rapids, MI 49503-2556 | 2017-06-26 |
| 1093165144 | David Jacob Hoogstra | Pediatrics | 100 Michigan St Ne # Mc085, Grand Rapids, MI 49503-2560 | 2016-06-20 |
| 1063895845 | Megan Elizabeth Conway | Pediatrics | 100 Michigan St Ne # Mc13, Grand Rapids, MI 49503-2560 | 2015-06-30 |
| 1205188653 | Vernon D. Vaandrager | Pediatrics | 3760 Ravine Vista Dr. Se, Grand Rapids, MI 49508-8867 | 2012-10-10 |
| 1386907491 | Jennifer Christine Curtis | Pediatrics | 35 Michigan St Ne Ste 5301, Grand Rapids, MI 49503-2530 | 2012-06-22 |
| 1942597729 | Miranda Louise Hillard | Pediatrics | 330 Barclay, Suite 300, Grand Rapids, MI 49503-2527 | 2011-06-30 |
| 1942509278 | Julie Ann Kirby | Pediatrics | 100 Michigan St Ne # Mc169, Grand Rapids, MI 49503-2560 | 2011-03-25 |
| 1306156443 | Spectrum Health Primary Care Partners | Pediatrics | 545 Michigan St Ne, Suite 203, Grand Rapids, MI 49503-5727 | 2010-10-07 |
| 1649583675 | Cheryl Lynn Dyksen | Pediatrics | 100 Michigan St Ne # 13, Grand Rapids, MI 49503-2560 | 2010-07-19 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49508 |
Please comment or provide details below to improve the information on KARA ANNE WILLOUGHBY.
| 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.