Wedgwood Christian Services - Medicare Primary Care in Grand Rapids, MI

Wedgwood Christian Services is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Grand Rapids, Michigan. The current practice location for Wedgwood Christian Services is 3300 36th St Se, Grand Rapids, Michigan. For appointments, you can reach them via phone at (616) 942-2110. The mailing address for Wedgwood Christian Services is 3300 36th St Se, Grand Rapids, Michigan and phone number is (616) 942-2110.

Wedgwood Christian Services is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1902997224. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (616) 942-2110.

Contact Information

Wedgwood Christian Services
3300 36th St Se
Grand Rapids
MI 49512-2810
(616) 942-2110
(616) 942-0589

Map and Direction


Primary Care Clinic Profile

Full NameWedgwood Christian Services
SpecialityClinic/Center
Location3300 36th St Se, Grand Rapids, Michigan
Authorized Official Name and PositionDaniel T Gowdy (CEO/PRESIDENT)
Authorized Official Contact6169422110
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Wedgwood Christian Services
3300 36th St Se
Grand Rapids
MI 49512-2810

Ph: (616) 942-2110
Wedgwood Christian Services
3300 36th St Se
Grand Rapids
MI 49512-2810

Ph: (616) 942-2110

NPI Details:

NPI Number1902997224
Provider Enumeration Date09/28/2006
Last Update Date11/01/2023

Medicare PECOS Information:

Medicare PECOS PAC ID6305813403
Medicare Enrollment IDO20040916000460

Medical Identifiers

Medical identifiers for Wedgwood Christian Services such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902997224NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary
261QR0405XClinic/center - Rehabilitation, Substance Use Disorder (* (Not Available))Secondary
322D00000XResidential Treatment Facility, Emotionally Disturbed Children CI410201226 (Michigan)Secondary
322D00000XResidential Treatment Facility, Emotionally Disturbed Children CI410201359 (Michigan)Secondary
322D00000XResidential Treatment Facility, Emotionally Disturbed Children CI410201082 (Michigan)Secondary
322D00000XResidential Treatment Facility, Emotionally Disturbed Children CICI410201003 (Michigan)Secondary
322D00000XResidential Treatment Facility, Emotionally Disturbed Children CI410201501 (Michigan)Secondary
3245S0500XSubstance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children CI410201502 (Michigan)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Wedgwood Christian Services acts as a billing entity for following providers:
Provider NameJoel M Sanchez
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1104147511
PECOS PAC ID: 0547415424
Enrollment ID: I20130226000144
Provider NamePaul Breithaupt
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1962851915
PECOS PAC ID: 7012340268
Enrollment ID: I20191203000535
Provider NameKatie Lynne Moyer
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1134615602
PECOS PAC ID: 7810375904
Enrollment ID: I20220601002257
Provider NameTamra Pell
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1548405384
PECOS PAC ID: 2961870589
Enrollment ID: I20221201001476
Provider NameBrina Tiemeyer
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1932602760
PECOS PAC ID: 2668837196
Enrollment ID: I20230504003154
Provider NameMichelle M Roberts
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1063898658
PECOS PAC ID: 9739536319
Enrollment ID: I20231104000175
Provider NameNicholas Bayer
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1295206936
PECOS PAC ID: 8628427994
Enrollment ID: I20231212001718
Provider NameJacklyn F Eding
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1609446434
PECOS PAC ID: 2365886587
Enrollment ID: I20240215002924
Provider NameChristopher S Moon
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1689124117
PECOS PAC ID: 6002252202
Enrollment ID: I20240311001563

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.