PINE REST CHRISTIAN MENTAL HEALTH SERVICES
NPI 1467463604
Nurse Practitioner in Grand Rapids, MI

Active since August 11, 2006
300 68TH ST SE, GRAND RAPIDS, MI 49548(616) 455-5000 Get Directions Write a Review

NPPES record last updated: November 4, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Pine Rest Christian Mental Health Services NPPES

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

PINE REST CHRISTIAN MENTAL HEALTH SERVICES (NPI 1467463604) is a healthcare organization registered as a nurse practitioner in Grand Rapids, Michigan and active in the NPI registry since August 2006. The organization lists Diane Fennema, Managed Care Administrator, as its authorized official.

NPPES Registry Identity

NPI1467463604
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NamePINE REST CHRISTIAN MENTAL HEALTH SERVICES
Location Address300 68TH ST SEGrand Rapids, MI 49548-6927
Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000
Organization SubpartYesParent: Pine Rest Christian Mental Heatlh Services
Authorized OfficialDiane FennemaManaged Care Administrator · (616) 281-6372
Enumeration DateAugust 11, 2006
Last NPPES UpdateNovember 4, 2020
NPPES CertifiedNovember 4, 2020
✔ NPI 1467463604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
300 68TH ST SE, Grand Rapids, MI 49548

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

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pine Rest Christian Mental Health Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

41

Medicare enrollment records show 41 clinicians reassign Medicare billing to Pine Rest Christian Mental Health Services, which bills Medicare for the services they deliver. Of these, 16 practice at this address and 30 within 10 miles. Listed here are the 20 practicing nearest to this location.

Nearest to this location (20)

See all 41
Nurse Practitioner
NPI 1790240455
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1083122790
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1801848189
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1679258701
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-9200
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1609547702
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1073180535
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1124753272
300 68TH ST SE BLDG E
Grand Rapids, MI 49548
(616) 455-9200
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1609547587
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1932510153
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOSSame address
Nurse Practitioner
NPI 1790040236
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOSSame address
Nurse Practitioner
NPI 1669899704
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1740528165
300 68TH ST SE
Grand Rapids, MI 49548
(616) 281-6315
✔ PECOSSame address
Nurse Practitioner
NPI 1427497957
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1740846013
300 68TH ST SE
Grand Rapids, MI 49548
(616) 258-7467
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1073285755
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5270
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1295261451
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1831929108
300 68TH ST SE
Grand Rapids, MI 49548
(164) 555-2706
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1992392807
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1235695651
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1497563548
300 68TH ST SE
Grand Rapids, MI 49548
(616) 455-5000
✔ PECOS0.1 mi
See all 41 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Pine Rest Christian Mental Health Services's NPI number?

The NPI number for Pine Rest Christian Mental Health Services is 1467463604. It was assigned to this organization in the NPPES registry on August 11, 2006.

Where is Pine Rest Christian Mental Health Services located?

Pine Rest Christian Mental Health Services is located at 300 68th St SE, Grand Rapids, MI 49548. The listed phone number is (616) 455-5000.

What is Pine Rest Christian Mental Health Services's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Pine Rest Christian Mental Health Services enrolled in Medicare?

Yes. Pine Rest Christian Mental Health Services is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pine Rest Christian Mental Health Services?

According to the CMS Revalidation Reassignment List (October 2026 release), 41 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Pine Rest Christian Mental Health Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 16 practice at this address and 30 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Pine Rest Christian Mental Health Services accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Pine Rest Christian Mental Health Services 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 Pine Rest Christian Mental Health Services was last updated on November 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.