Active NPI
Calvin Mark Meuzelaar, LISW, LMSW
- Clinical Social Worker
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801019786
- Practice address
- 300 68TH St SE
Grand Rapids, MI 49548-6927 - Phone
- (616) 455-5270
- Fax
- (616) 455-5460
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 00572 | IA | |
| Clinical Social Worker | 1041C0700X | 6801019786 | MI | Primary |
Addresses
Primary practice location
300 68TH St SE
Grand Rapids, MI 49548-6927
Mailing address
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5270
Other practice location 1
2611 Washington St
Pella, IA 50219-7924
Phone (641) 628-9599
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0136234 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pine Rest Christian Mental Health Services
Practice addresses (Care Compare)
300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000
6200 Aurora Ave
Urbandale, IA 50322-2800
Phone (515) 331-0303
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00572 | IA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Rest Christian Mental Health Services | Social Worker | Current | Accepting new patients |
| Pine Rest Christian Mental Health Services | Current | Accepting new patients | |
| Pine Rest Christian Mental Health Services | Social Worker | Current | Accepting new patients |
Locations
2611 Washington St
Pella, IA 50219
Phone (641) 628-9599
300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Social Worker
- Grand Rapids, MI
- NPI 1922019157
-
- Psychiatry Physician
- Pella, IA
- NPI 1326117805
Social Worker
-
- Professional Counselor
- Grand Rapids, MI
- NPI 1386015683
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521590400000",
"number": "1013952167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-455-5270",
"fax_number": "616-455-5460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-455-5270",
"fax_number": "616-455-5460"
}
],
"practiceLocations": [
{
"address_1": "2611 Washington St",
"address_purpose": "LOCATION",
"city": "Pella",
"state": "IA",
"postal_code": "502197924",
"country_code": "US",
"telephone_number": "641-628-9599",
"fax_number": "641-621-1493",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEUZELAAR",
"first_name": "CALVIN",
"middle_name": "MARK",
"credential": "LISW, LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2018-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "00572",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801019786",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0136234",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.