Mercy General Physician Network – Family Medicine Physician, NPI 1023056744
Family Medicine Physician
Main info
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Mercy General Physician Network
1310 Wisconsin St Ste 301
Grand Haven, MI 494172472
Phone: (616) 847-1860
Fax: (616) 844-4527
Type: Location
1223 Mercy Dr
Muskegon, MI 494441829
Phone: (231) 672-3177
Fax: (231) 672-3178
Type: Location
3443 Farr Rd
Fruitport, MI 494158779
Phone: (231) 672-2900
Fax: (231) 672-2901
Type: Location
15151 Stanton St
West Olive, MI 494608543
Phone: (616) 296-1020
Fax: (616) 296-1030
Type: Location
3587 Henry St Ste 200
Norton Shores, MI 494416732
Phone: (231) 672-6700
Fax: (231) 672-6749
Type: Location
1675 Leahy St Ste 301A
Muskegon, MI 494425543
Phone: (231) 728-5000
Fax: (231) 728-5041
Type: Location
6401 Prairie St Ste 2800
Norton Shores, MI 494447841
Phone: (231) 724-7848
Fax: (231) 724-7850
Type: Location
2006 Holton Rd
Muskegon, MI 494451505
Phone: (231) 672-3333
Fax: (231) 672-6520
Type: Location
1150 E Sherman Blvd Ste 1175
Muskegon, MI 494441885
Phone: (231) 672-6740
Fax: (231) 672-6749
Type: Location
1310 Wisconsin St Ste 100
Grand Haven, MI 494172472
Phone: (616) 844-4701
Fax: (616) 847-1863
Type: Location
221 S Quarterline Rd
Muskegon, MI 494421432
Phone: (231) 672-7180
Fax: (231) 672-7181
Type: Location
6401 Prairie St Ste 2600
Norton Shores, MI 494447842
Phone: (231) 727-7900
Fax: (231) 727-7914
Type: Location
1778 Sanford St
Muskegon, MI 494412537
Phone: (231) 727-4444
Fax: (231) 727-4451
Type: Location
601 W Savidge St
Spring Lake, MI 494561620
Phone: (231) 672-3100
Fax: (231) 672-3102
Type: Location
1150 E Sherman Blvd Ste 1100
Muskegon, MI 494444607
Phone: (231) 672-2203
Fax: (231) 672-2992
Type: Location
1675 Leahy St Ste 201A
Muskegon, MI 494425542
Phone: (231) 672-7800
Fax: (231) 672-7801
Type: Location
6207 Harvey St Ste A
Norton Shores, MI 494447861
Phone: (231) 672-2230
Fax: (231) 672-2231
Type: Location
3535 Park St Ste 110
Norton Shores, MI 494443795
Phone: (231) 672-3155
Fax: (231) 672-3157
Type: Location
1909 Ruddiman Dr
Muskegon, MI 494453147
Phone: (231) 672-7466
Fax: (231) 744-9027
Type: Location
1310 Wisconsin St Ste 103
Grand Haven, MI 494172472
Phone: (616) 846-2640
Fax: (616) 846-3100
Type: Location
US Post Office - North Muskegon, 404, Center Street, North Muskegon, Muskegon County, Michigan, 49445, United States
MUSKEGON, MI 494431848
Phone: (231) 672-2120
Fax: (231) 728-5981
Type: Mailing
2006, Holton Road, Muskegon Township, Muskegon County, Michigan, 49445, United States
MUSKEGON, MI 49445
Phone: (231) 672-3333
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-11-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (192 days ago).
Enrollment records
1
Earliest due date
2025-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040923000255 | O | Clinic/Group Practice | MI | 2025-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49417)
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