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CHERRY STREET SERVICES INC NPI 1780742015


NPI Information

NPI: 1780742015
Provider Name: CHERRY STREET SERVICES, INC

Doing Business As: GRAND RAPIDS PEDIATRIC

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
100 CHERRY ST SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 965-8200
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CHERRY STREET SERVICES, INC is a pediatrics in Grand Rapids, MI. The provider is 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. CHERRY STREET SERVICES, INC NPI is 1780742015. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Grand Rapids Pediatric.

The provider's business location address is:

100 CHERRY ST SE
GRAND RAPIDS, MI
ZIP 49503-526
Phone: (616) 965-8200
Fax: (616) 940-5366

The provider's authorized official is Chris Shea .
The authorized official title is Ceo and has the following contact phone number (616) 776-2120.

The enumeration date for this NPI number is 12/6/2006 and was last updated on 10/19/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics4301036769MICHIGANYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1231878MEDICARE OSCAR/CERTIFICATIONMICHIGAN

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

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