SPECTRUM HEALTH HOSPITALS NPI 1366438632

NPI Information

NPI: 1366438632
Provider Name: SPECTRUM HEALTH HOSPITALS
Classification: Clinic/Center - 261QA1903X
Specialization: Ambulatory Surgical
Entity Type: Organization
Doing Business As: SPECTRUM HEALTH ENDOSCOPY CENTER
CLIA Number: 23D0988683
Address: 4100 LAKE DR SE
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 391-7580

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NPI Details

SPECTRUM HEALTH HOSPITALS is an ambulatory surgical clinic center in Grand Rapids, MI. SPECTRUM HEALTH HOSPITALS NPI is 1366438632. The provider is registered as an organization entity type.
The provider Is Doing Business As Spectrum Health Endoscopy Center.

The provider's business location address is:

4100 LAKE DR SE
GRAND RAPIDS, MI
ZIP 49546-292
Phone: (616) 391-7580

The provider's authorized official is Douglas D. Welday .
The authorized official title is Vice President Of Finance and has the following contact phone number (616) 391-2525.

The CLIA number assigned to this NPI record is 23D0988683 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2005 and was last updated on 10/21/2014.

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	261QA1903X	Clinic/Center	Ambulatory Surgical	416830	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	40124	OTHER	MICHIGAN	BLUE CROSS
2	5170255	MEDICAID	MICHIGAN
3	230038	MEDICARE ID-TYPE UNSPECIFIED

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: 3/30/2025

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