Individual provider Active NPI

Jainya Sannoh

  • Licensed Practical Nurse
  • Grand Rapids, MI
National Provider Identifier
1114841756
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703111106 Issued in MI
Practice address
364 Summer Cir SE
Grand Rapids, MI 49548-7021
Phone
(616) 308-0608
NPI assigned
Aug 6, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703111106 MI Primary

Addresses

Primary practice location

364 Summer Cir SE
Grand Rapids, MI 49548-7021

Mailing address

364 Summer Cir SE
Grand Rapids, MI 49548-7021

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": "1785974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1114841756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 SUMMER CIR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495487021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 SUMMER CIR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495487021",
            "telephone_number": "616-308-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANNOH",
        "first_name": "JAINYA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-08-06",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703111106",
            "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 Aug 6, 2026; 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.