| Grand River Family Care, Pc | |
|
1881 W Grand River Ave Okemos MI 48864-1840 | |
| (517) 339-2116 | |
| (517) 339-4620 |
| Full Name | Grand River Family Care, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1881 W Grand River Ave, Okemos, Michigan |
| Authorized Official Name and Position | Quinn Bosworth (OWNER) |
| Authorized Official Contact | 5173392116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand River Family Care, Pc 1881 W Grand River Ave Okemos MI 48864-1840 Ph: (517) 339-2116 | Grand River Family Care, Pc 1881 W Grand River Ave Okemos MI 48864-1840 Ph: (517) 339-2116 |
| NPI Number | 1396301719 |
|---|---|
| Provider Enumeration Date | 05/10/2019 |
| Last Update Date | 05/10/2019 |
| Medicare PECOS PAC ID | 8628304516 |
|---|---|
| Medicare Enrollment ID | O20190730004654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396301719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Quinn Michael Bosworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063440592 PECOS PAC ID: 9234103292 Enrollment ID: I20040825000003 |
| Provider Name | David R Neff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740326800 PECOS PAC ID: 2769477173 Enrollment ID: I20041025000576 |
| Provider Name | Kyle A Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831744457 PECOS PAC ID: 6901135821 Enrollment ID: I20190831000069 |
| Provider Name | Emily A Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710531686 PECOS PAC ID: 8527468354 Enrollment ID: I20210615002422 |
| Provider Name | Elysha A Keener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861076465 PECOS PAC ID: 5799185575 Enrollment ID: I20210616000715 |
| Provider Name | Zachary T Goldstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457911877 PECOS PAC ID: 5991197675 Enrollment ID: I20220111000257 |
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