| Homeward Physicians , Pllc | |
|
2627 E Beltline Ave Se Ste 220 Grand Rapids MI 49546-5937 | |
| (844) 279-8615 | |
| Not Available |
| Full Name | Homeward Physicians , Pllc |
|---|---|
| Speciality | General Practice |
| Location | 2627 E Beltline Ave Se Ste 220, Grand Rapids, Michigan |
| Authorized Official Name and Position | Jonathan Rouwhorst (CHIEF OPERATION OFFICER) |
| Authorized Official Contact | 6164028353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Homeward Physicians , Pllc 2 S Park St San Francisco CA 94107-2592 Ph: () - | Homeward Physicians , Pllc 2627 E Beltline Ave Se Ste 220 Grand Rapids MI 49546-5937 Ph: (844) 279-8615 |
| NPI Number | 1538828314 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 10/06/2023 |
| Medicare PECOS PAC ID | 8921488586 |
|---|---|
| Medicare Enrollment ID | O20220629002254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538828314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Susan K Owen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871820514 PECOS PAC ID: 6204962020 Enrollment ID: I20100331000948 |
| Provider Name | Jonathan Rouwhorst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508120122 PECOS PAC ID: 9133438633 Enrollment ID: I20160902000717 |
| Provider Name | Amanda Tegge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790540292 PECOS PAC ID: 3779925680 Enrollment ID: I20240523002166 |
| Provider Name | Nicole Joanne Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689422172 PECOS PAC ID: 8527400191 Enrollment ID: I20240528003179 |
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