Graceann Mary Robertson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301008866 Issued in MI

Practice address

7150 Kalamazoo Ave SE Ste C
Caledonia, MI 49316-9197

Phone

(616) 219-0159

Fax

(616) 219-0124

NPI assigned

Jul 31, 2006

Last updated

Mar 19, 2024By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, ME2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acorn Hill Psychology PLLC

  • Clinical Psychologist
  • Caledonia, MI
  • NPI 1861930158

  ME

  Medicare reassignment Authorized official
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment NPD
• Mikids Pediatrics, PC

  • Pediatrics Physician
  • Caledonia, MI
  • NPI 1043722176
  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• Chapman Chiropractic Center P a

  • Chiropractor
  • Scarborough, ME
  • NPI 1760562953
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1063428134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 KALAMAZOO AVE SE STE C",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169197",
            "telephone_number": "616-219-0159",
            "fax_number": "616-219-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 KALAMAZOO AVE SE STE C",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169197",
            "telephone_number": "616-219-0159",
            "fax_number": "616-219-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "GRACEANN",
        "middle_name": "MARY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301008866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "680D117560",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Restoration Chiropractic, PLLC
• Richard C. Robertson DDS PLC
• Rite Aid of Michigan Inc (Rite Aid Pharmacy 01532)
• Guixiu L Rives
• Road to Redemption LLC
• Richard Clyde Robertson, DDS
• Robinson Dental Caledonia (Robinson Dental)
• Maya Rooks
• Erin Lynn Roon, M.A. CCC-SLP
• Amanda Marie Root, PMHNP-BC

• Psychologist in Caledonia, MI
• Providers in Caledonia, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.