Active NPI
Daniel Jason Matthews
- Behavior Technician
- Grand Rapids, MI
National Provider Identifier
1053901553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 2814 Woodcliff Cir SE
Grand Rapids, MI 49506-3155 - Phone
- (855) 832-6727
- NPI assigned
- Jan 19, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
2814 Woodcliff Cir SE
Grand Rapids, MI 49506-3155
Mailing address
4775 Drummond Blvd SE Apt 104
Kentwood, MI 49508-5193
Phone (407) 394-8031
Other practice location 1
4775 Drummond Blvd SE Apt 104
Kentwood, MI 49508-5193
Phone (407) 394-8031
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": "1611014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1053901553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4775 DRUMMOND BLVD SE APT 104",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495085193",
"telephone_number": "407-394-8031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2814 WOODCLIFF CIR SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495063155",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [
{
"address_1": "4775 Drummond Blvd SE Apt 104",
"address_purpose": "LOCATION",
"city": "Kentwood",
"state": "MI",
"postal_code": "495085193",
"country_code": "US",
"telephone_number": "407-394-8031",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATTHEWS",
"first_name": "DANIEL",
"middle_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-19",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"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 Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.