J Patrick Duiven PSYD PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301002423 Issued in MI

Legal business name

J PATRICK DUIVEN PSYD PC

Practice address

4133 Embassy Dr SE
Grand Rapids, MI 49546-2418

Phone

(616) 956-6700

Fax

(616) 956-6773

NPI assigned

Oct 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. J Patrick Duiven, PSYD

Title

President/Owner

Phone

(616) 956-6700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• J. Patrick Duiven, PSY.D.

  • Clinical Psychologist
  • Grand Rapids, MI
  • NPI 1972685527

  CO

  Medicare reassignment
• Karen Marie Elbert, LMSW

  • Social Worker
  • Ada, MI
  • NPI 1598870362
  NPD (past)

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1124328265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 EMBASSY DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462418",
            "telephone_number": "616-956-6700",
            "fax_number": "616-956-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 EMBASSY DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462418",
            "telephone_number": "616-956-6700",
            "fax_number": "616-956-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J PATRICK DUIVEN PSYD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "DUIVEN",
        "authorized_official_first_name": "J PATRICK",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "616-956-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301002423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlee Jo Iwema, LLPC
• Sara Iwema
• Rufus Onus Iyoha, OTR
• Amelie Izokaitis
• Andrew R Izzo, DO
• J&E Health Ventures LLC
• Darcy L Jaarsma, M.A,
• Adrianne Marie Jabaay, NP
• Michael R Jabara, MD
• Nikita S. Jaber, OD

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.