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INTERNAL MEDICINE AND PEDIATRICS OF WEST MICHIGAN
NPI 1104170661
Internal Medicine in Grand Rapids, MI

Active since November 06, 2012CLIA 23D2049759 · Waiver
655 KENMOOR AVE SE, SUITE 200, GRAND RAPIDS, MI 49546(616) 363-7690(616) 942-8917 Get Directions Write a Review

NPPES record last updated: April 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Internal Medicine And Pediatrics Of West Michigan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTERNAL MEDICINE AND PEDIATRICS OF WEST MICHIGAN (NPI 1104170661) is a healthcare organization registered as an internal medicine in Grand Rapids, Michigan and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through November 13, 2026 and lists Deanna Rawlings, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1104170661
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameINTERNAL MEDICINE AND PEDIATRICS OF WEST MICHIGAN
Location Address655 KENMOOR AVE SE, SUITE 200Grand Rapids, MI 49546
Mailing Address655 Kenmoor Ave Se, Suite 200Grand Rapids, MI 49546 · (616) 363-7690 · Fax (616) 942-8917
Phone(616) 363-7690
Fax(616) 942-8917
Organization SubpartNo
Authorized OfficialDeanna RawlingsOffice Manager · (616) 323-3227
Enumeration DateNovember 6, 2012
Last NPPES UpdateApril 15, 2024
✔ NPI 1104170661 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301071009
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
655 KENMOOR AVE SE, Grand Rapids, MI 49546
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2049759

Internal Medicine And Pediatrics Of West Michigan · Grand Rapids, MI
Active · expires Nov 13, 2026
CLIA Number23D2049759
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2024
Certificate Expiration DateNovember 13, 2026
Laboratory DirectorMichael J. App
Laboratory Phone(616) 363-7690
Laboratory LocationInternal Medicine And Pediatrics Of West Michigan655 Kenmoor Avenue SE Suite 200, Grand Rapids, MI 49546
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN JACKSON AU.D.
Audiologist
655 KENMOOR AVE SE, STE A
GRAND RAPIDS, MI 49546
Kent County (616) 575-1212
GRAND RAPIDS EAR NOSE & THROAT CENTER PLLC
Otolaryngology
655 KENMOOR AVE SE, SUITE A
GRAND RAPIDS, MI 49546
Kent County (616) 575-1212
KAREN J GARBOWITZ PA-C
Physician Assistant
655 KENMOOR AVE SE, SUITE 200
GRAND RAPIDS, MI 49546
Kent County (616) 949-5600
JOHN MICHAEL KOSTA M.D.
Otolaryngology
655 KENMOOR AVE SE, SUITE A
GRAND RAPIDS, MI 49546
Kent County (616) 575-1212
ROBYN ERIN STRANGWAYS M.A.
Audiologist
655 KENMOOR AVE SE
GRAND RAPIDS, MI 49546
Kent County (616) 575-1213
MARK ROBERT WINKLE M.D.
Otolaryngology
655 KENMOOR AVE SE, SUITE A
GRAND RAPIDS, MI 49546
Kent County (616) 575-1212
ALLISON ANN PELTON M.A.
Audiologist
655 KENMOOR AVE SE
GRAND RAPIDS, MI 49546
Kent County (616) 575-1213
AMANDA MILLER PA
Physician Assistant
655 KENMOOR AVE SE, SUITE 200
GRAND RAPIDS, MI 49546
Kent County (616) 949-5600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Internal Medicine And Pediatrics Of West Michigan's NPI number?

The NPI number for Internal Medicine And Pediatrics Of West Michigan is 1104170661. It was assigned to this organization in the NPPES registry on November 6, 2012.

Where is Internal Medicine And Pediatrics Of West Michigan located?

Internal Medicine And Pediatrics Of West Michigan is located at 655 Kenmoor Ave SE Suite 200, Grand Rapids, MI 49546. The listed phone number is (616) 363-7690.

What is Internal Medicine And Pediatrics Of West Michigan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Internal Medicine And Pediatrics Of West Michigan hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2049759) is associated with this NPI, valid through November 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Internal Medicine And Pediatrics Of West Michigan accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Care Network of Michigan list Internal Medicine And Pediatrics Of West Michigan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Internal Medicine And Pediatrics Of West Michigan was last updated on April 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.