KEVIN EDWARD FITZGERALD MD NPI 1144281080

NPI Information

NPI: 1144281080
Provider Name: KEVIN EDWARD FITZGERALD, MD
Classification: Pain Medicine - 208VP0014X
Entity Type: Individual

Specialization: Interventional Pain Medicine

PECOS Registration: Yes

Address:
4100 LAKE DR SE
STE 305
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 285-1377
Get Directions

Kevin Edward Fitzgerald, MD is an interventional pain medicine pain medicine in Grand Rapids, MI. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. Kevin Edward Fitzgerald, MD NPI is 1144281080. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4100 LAKE DR SE
STE 305
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 285-1377
Fax: (616) 285-1006

The NPI 1144281080 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/30/2006 and was last updated on 11/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208VP0014X	Pain Medicine	Interventional Pain Medicine	4301044533	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00057547	OTHER		RAILROAD MEDICARE
2	4507437-10	MEDICAID	MICHIGAN
3	B43288	MEDICARE UPIN
4	23113	OTHER		HEALTH PLAN OF MICHIGAN
5	4532350-10	MEDICAID	MICHIGAN
6	550410072	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD
7	4642669	OTHER		AETNA
8	7000144071	OTHER		PRIORITY HEALTH
9	5648777	OTHER		CIGNA
10	4592438-10	MEDICAID	MICHIGAN
11	D16000014	MEDICARE PIN	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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