DR FRED PLLC NPI 1700625761

NPI Information

  • NPI: 1700625761
  • Provider Name: DR FRED PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 2100 RAYBROOK ST SE
    STE 100B
    GRAND RAPIDS, MI
    ZIP 49546
  • Phone: (616) 320-0096

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NPI Details

DR FRED PLLC is a family medicine in Grand Rapids, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR FRED PLLC NPI is 1700625761. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2100 RAYBROOK ST SE
STE 100B
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 320-0096
Fax: (616) 320-0097

The provider's authorized official is Fredric Reyelts .
The authorized official title is President / Cmo and has the following contact phone number (616) 320-0096.

The enumeration date for this NPI number is 5/20/2024 and was last updated on 11/19/2025.

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
1363AM0700XPhysician AssistantMedicalNo
2174400000XSpecialistNo
3363LA2200XNurse PractitionerAdult HealthNo
4207Q00000XFamily MedicineYes

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: 11/21/2025

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