Healthcare Provider Details

I. General information

NPI: 1285588442
Provider Name (Legal Business Name): SHERIDAN COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 E BELTLINE AVE NE
GRAND RAPIDS MI
49525-4598
US

IV. Provider business mailing address

301 N MAIN ST
SHERIDAN MI
48884-9235
US

V. Phone/Fax

Practice location:
  • Phone: 989-291-6304
  • Fax:
Mailing address:
  • Phone: 989-291-6304
  • Fax: 989-291-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES DIMITRIOU
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 989-291-6304