Individual provider Active NPI

Richard John Navis, MSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1215200464
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094028 Issued in MI
Practice address
1000 Parchment Dr SE
Grand Rapids, MI 49546-3663
Phone
(616) 957-9112
Fax
(616) 957-2409
NPI assigned
Feb 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801094028 MI Primary

Addresses

Primary practice location

1000 Parchment Dr SE
Grand Rapids, MI 49546-3663

Mailing address

1025 Ardmore St SE
Grand Rapids, MI 49507-2710
Phone (616) 550-0794

Other identifiers 1

IdentifierTypeStateIssuer
6801094028OtherMISTATE CLINICAL LICENSE

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215200464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 ARDMORE ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072710",
            "telephone_number": "616-550-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463663",
            "telephone_number": "616-957-9112",
            "fax_number": "616-957-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVIS",
        "first_name": "RICHARD",
        "middle_name": "JOHN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CLINICAL LICENSE",
            "identifier": "6801094028",
            "state": "MI"
        }
    ],
    "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 Jul 21, 2022; 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.