MEDICARE: HEARTLAND PRIMARY CARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1528880705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND PRIMARY CARE PLLC

Provider Business Mailing Address
First Line	:	123 E CASS ST
Second Line	:
City	:	GREENVILLE
State	:	MI
Zip	:	48838-1905
Country	:	US
Telephone Number	:	616-221-4302
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 E CASS ST
Second Line	:
City	:	GREENVILLE
State	:	MI
Zip	:	48838-1905
Country	:	US
Telephone Number	:	616-221-4302
Fax Number	:	616-232-2034

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	CATHERINE GRIMM
Credential	:
Telephone Number	:	616-221-4302

Provider Enumeration Date	:	10/29/2024
Last Update Date	:	02/04/2026

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Directions to “HEARTLAND PRIMARY CARE PLLC ” Practice Location

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