=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629558978
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTHVIEW HEALTH SPECIALISTS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2018
-----------------------------------------------------
Last Update Date | 07/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 770 KENMOOR AVE SE STE 100
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49546-8602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-272-3533
-----------------------------------------------------
Fax | 616-259-4839
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 ROSEHILL RD
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49202-1762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-212-9000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE MANAGER
-----------------------------------------------------
Name | JOSEPH DONALD MEAD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 517-212-9000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------