Kelly Sue Boprie, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801091326 Issued in MI

Practice address

1115 Ball Ave NE
Building C
Grand Rapids, MI 49505-5904

Phone

(616) 459-7215

Fax

(616) 451-0020

NPI assigned

Apr 7, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Michigan Eating Disorder SpecialistsGroup PAC ID 3577931930, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• West Michigan Eating Disorder Specialists

  • Social Worker
  • Wyoming, MI
  • NPI 1477292480
  Medicare reassignment Care Compare group NPD
• Arbor Circle Corporation

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1174601512
  NPD (past)
• Arbor Circle Corporation

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1740585330
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1023307337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "address_2": "BUILDING C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-459-7215",
            "fax_number": "616-451-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "address_2": "BUILDING C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-459-7215",
            "fax_number": "616-451-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOPRIE",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Lynn Booth, PA
• Tracy Marie Booth, MA, RDN
• Jeffrey Alan Bootzin, EDS, LLP
• Lauren Bootzin, MD
• Chad Michael Boprie, CTRS, ATRIC
• Nirali Bora, M.D.
• William Boras III, O.D.
• April Borchert, LMSW
• Lisa Sue Borden, BS
• Stefano John Bordoli, M.D.

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.

Verify at the official NPI Registry.