Individual provider Active NPI

Anthony Alan Matson, MSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1215227129
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092929 Issued in MI
Practice address
200 Eastern Ave SE
Grand Rapids, MI 49503-4735
Phone
(616) 776-0891
Fax
(616) 233-0718
NPI assigned
Apr 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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 6801092929 MI Primary

Addresses

Primary practice location

200 Eastern Ave SE
Grand Rapids, MI 49503-4735

Mailing address

330 Eastern Ave SE
Grand Rapids, MI 49503-4737
Phone (616) 776-0891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160526000251 MI Practitioner - Clinical Social Worker 6901196328 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arbor Circle CorporationGroup PAC ID 2668362393, 18 clinicians

Practice addresses (Care Compare)

1115 Ball Ave NE
Grand Rapids, MI 49505-5904
Phone (616) 459-7215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801092929MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Circle Corporation Clinical CurrentSince May 19, 2016 Accepting new patients
Project Rehab Clinical Past Accepting new patients
Life Guidance Services Social Worker Past Accepting new patients

Locations

1101 Ball Ave NE
Grand Rapids, MI 49505
Phone (616) 456-7775

1115 Ball Ave NE
Grand Rapids, MI 49505
Phone (616) 451-3001

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1215227129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 EASTERN AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034737",
            "telephone_number": "616-776-0891",
            "fax_number": "616-233-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EASTERN AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034735",
            "telephone_number": "616-776-0891",
            "fax_number": "616-233-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSON",
        "first_name": "ANTHONY",
        "middle_name": "ALAN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-12",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.