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CHERRY STREET SERVICES INC. NPI 1770656605


NPI Information

NPI: 1770656605
Provider Name: CHERRY STREET SERVICES, INC.

Doing Business As: BURTON HEALTH CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D0991766

Address:
2125 BUCHANAN SW
GRAND RAPIDS, MI
ZIP 49507
Phone: (616) 247-3638
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CHERRY STREET SERVICES, INC. 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. CHERRY STREET SERVICES, INC. NPI is 1770656605. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Burton Health Center.

The provider's business location address is:

2125 BUCHANAN SW
GRAND RAPIDS, MI
ZIP 49507
Phone: (616) 247-3638
Fax: (616) 247-0780

The provider's authorized official is Chris Shea .
The authorized official title is Ceo and has the following contact phone number (616) 776-2129.

The CLIA number assigned to this NPI record is 23D0991766 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/16/2006 and was last updated on 2/7/2013.


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
1104100000XSocial WorkerMICHIGANNo
2122300000XDentistNo
3207Q00000XFamily MedicineYes
4208000000XPediatricsNo

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
1231852MEDICARE 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: 11/14/2023

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