Individual provider Active NPI

Regan J Yaw

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1023536711
Registry record updated Sep 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1115 Ball Ave NE
Grand Rapids, MI 49505-5904
Phone
(616) 456-6571
NPI assigned
Sep 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1115 Ball Ave NE
Grand Rapids, MI 49505-5904

Mailing address

1498 E Sessions Rd
Sheridan, MI 48884-9713
Phone (616) 902-9131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1504310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504310400000",
    "number": "1023536711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 E SESSIONS RD",
            "city": "SHERIDAN",
            "state": "MI",
            "postal_code": "488849713",
            "telephone_number": "616-902-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-456-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAW",
        "first_name": "REGAN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-02",
        "last_updated": "2017-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.