COREWELL HEALTH GRAND RAPIDS HOSPITALS
NPI 1356683569
Internal Medicine in Grand Rapids, MI

Active since March 26, 2013CLIA 23D1015840 · Waiver
3350 BROADMOOR AVE SE, GRAND RAPIDS, MI 49512(616) 391-8020 Get Directions Write a Review

NPPES record last updated: November 2, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Corewell Health Grand Rapids Hospitals NPPES

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

COREWELL HEALTH GRAND RAPIDS HOSPITALS (NPI 1356683569) is a healthcare organization registered as an internal medicine in Grand Rapids, Michigan and active in the NPI registry since March 2013. The organization holds a CLIA Waiver certificate valid through August 13, 2027 and lists Pauline Krywanski, Svp, Finance, as its authorized official.

NPPES Registry Identity

NPI1356683569
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSPECTRUM HEALTH HOSPITALS
Location Address3350 BROADMOOR AVE SEGrand Rapids, MI 49512-2867
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Organization SubpartYes
Authorized OfficialPauline KrywanskiSvp, Finance · (616) 486-2253
Enumeration DateMarch 26, 2013
Last NPPES UpdateNovember 2, 2023
NPPES CertifiedNovember 2, 2023
NPI 1356683569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.

Also ListedEmergency MedicineTaxonomy 207P00000X
Also ListedPhysician AssistantTaxonomy 363A00000X
3350 BROADMOOR AVE SE, Grand Rapids, MI 49512

Other Names 1

Doing Business AsCorewell Health Grand Rapids Hospitals

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
23D1015840
Facility Type
Federally Qualified Health Center
Certificate Effective Date
August 14, 2025
Certificate Expiration Date
August 13, 2027
Laboratory Director
AARON ZIEGLER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Corewell Health Grand Rapids Hospitals to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Physician Assistant
3350 BROADMOOR AVE SE
GRAND RAPIDS, MI 49512
Durable Medical Equipment & Medical Supplies
3350 BROADMOOR AVE SE
KENTWOOD, MI 49512
Physical Therapist
3350 BROADMOOR AVE SE
GRAND RAPIDS, MI 49512
Internal Medicine
3350 BROADMOOR AVE SE
GRAND RAPIDS, MI 49512

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356683569, enumerated as an "organization" on March 26, 2013.

The provider is located at 3350 BROADMOOR AVE SE GRAND RAPIDS, MI 49512 and the phone number is (616) 391-8020.

Internal Medicine with taxonomy code 207R00000X.