Individual provider Active NPI

Jacqueline Levette Sarvis

  • Orientation and Mobility Training Rehabilitation Counselor
  • Grand Rapids, MI
National Provider Identifier
1104406651
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orientation and Mobility Training Rehabilitation CounselorTaxonomy code 225CX0006X
Practice address
1492 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Phone
(616) 940-0040
NPI assigned
Apr 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X MI
Orientation and Mobility Training Rehabilitation Counselor 225CX0006X MI Primary

Addresses

Primary practice location

1492 E Beltline Ave SE
Grand Rapids, MI 49506-4336

Mailing address

1492 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Phone (616) 940-0040

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": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1104406651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 E BELTLINE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064336",
            "telephone_number": "616-940-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 E BELTLINE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064336",
            "telephone_number": "616-940-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARVIS",
        "first_name": "JACQUELINE",
        "middle_name": "LEVETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "225CX0006X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Orientation and Mobility Training Provider",
            "state": "MI",
            "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 Apr 9, 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.

Verify at the official NPI Registry.