{"npi":"1285687467","type":"NPI-1","status":"active","name":{"display":"Dr. Fredric Reyelts MD","other":[],"first":"FREDRIC","last":"REYELTS","middle":"ALAN","credential":"MD"},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"2084P0800X","description":"Psychiatry","primary":false,"state":"MI","license":"4301051511"},{"code":"2084P0805X","description":"Geriatric Psychiatry Physician","primary":false,"state":"MI","license":"4301051511"},{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"MI","license":"4301051511"}]},"addresses":[{"purpose":"LOCATION","street_1":"801 BROADWAY AVE NW STE 105","city":"GRAND RAPIDS","state":"MI","postal_code":"495044496","country_code":"US","phone":"6166857500","fax":"6167857511"},{"purpose":"MAILING","street_1":"801 BROADWAY AVE NW STE 105","city":"GRAND RAPIDS","state":"MI","postal_code":"495044496","country_code":"US","phone":"6166857500","fax":"6166857511"}],"license":{"state":"MI","number":"4301051511"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"3415813","state":"MI","issuer":null},{"type_code":"05","label":"Medicaid","value":"4106189","state":"MI","issuer":null},{"type_code":"05","label":"Medicaid","value":"4593050","state":"MI","issuer":null},{"type_code":"05","label":"Medicaid","value":"4878865","state":"MI","issuer":null},{"type_code":"05","label":"Medicaid","value":"2995094","state":"MI","issuer":null},{"type_code":"05","label":"Medicaid","value":"4155657","state":"MI","issuer":null},{"type_code":"05","label":"Medicaid","value":"4593060","state":"MI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20060906000217","type_code":"14-01","type_desc":"PRACTITIONER - GENERAL PRACTICE","state":"MI","pac_id":"9234133232"}]},"enumeration_date":"2006-05-18","last_updated":"2023-06-07","_meta":{"source":"NPPES","snapshot_date":"2023-06-07","doc_url":"https://findmynpi.com/api"}}