PINE REST CHRISTIAN MENTAL HEALTH SERVICES
NPI 1679777049
Internal Medicine - Addiction Medicine in Grand Rapids, MI
NPI Status: Active since June 12, 2007
Contact Information
243 68TH ST SE
GRAND RAPIDS, MI
ZIP 49548
Phone: (616) 281-6836
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Organization
- Internal Medicine
- Addiction Medicine
- Accepts Insurance
About PINE REST CHRISTIAN MENTAL HEALTH SERVICES
This page provides the complete NPI Profile along with additional information for Pine Rest Christian Mental Health Services, an internist established in Grand Rapids, Michigan operating as a Internal Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1679777049 assigned on June 2007. The practitioner's primary taxonomy code is 207RA0401X. The provider is registered as an organization and their NPI record was last updated June 2026. Pine Rest Christian Mental Health Services operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Diane M Fennema (Managed Care Administrator)
- NPI
- 1679777049
- Provider Name
- PINE REST CHRISTIAN MENTAL HEALTH SERVICES
- Entity Type
- Organization
- Location Address
- 243 68TH ST SE GRAND RAPIDS, MI 49548
- Location Phone
- (616) 281-6836
- Mailing Address
- 300 68TH ST SE GRAND RAPIDS, MI 49548
- Mailing Phone
- (616) 455-5000
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 06-12-2007
- Last Update Date
- 06-18-2026
- Code Navigator
An internist like Pine Rest Christian Mental Health Services is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Addiction Medicine
- Taxonomy Code
- 207RA0401X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | |
| 3 | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | |
| 4 | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
| 5 | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | |
| 6 | 104100000X | Behavioral Health & Social Service Providers | Social Worker | |
| 7 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 8 | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
| 9 | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | |
| 10 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | 410334 (MI) |
| 11 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | |
| 12 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Wellpoint Essential Bronze 4000 HSA (+ Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
- Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Catastrophic (+ Incentives) - HMO
- Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Gold POS 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 750920290 | OTHER (01) | MI | BCBS DETOX |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1679777049, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1679777049, enumerated as an "organization" on June 12, 2007.
The provider is located at 243 68TH ST SE GRAND RAPIDS, MI 49548 and the phone number is (616) 281-6836.
Internal Medicine with taxonomy code 207RA0401X and a focus in Addiction Medicine.
The provider might be accepting Accepts: WellPoint, Blue Cross Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
