Christian Robert Komor, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301005480 Issued in MI

Practice address

235 Louis St NW
Grand Rapids, MI 49503-2600

Phone

(616) 706-6951

NPI assigned

Oct 15, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1225409220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 CHILDERS ST",
            "address_2": "PMB 24256",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325349630",
            "telephone_number": "616-706-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 LOUIS ST NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032600",
            "telephone_number": "616-706-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOR",
        "first_name": "CHRISTIAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301005480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "M032644",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OD14598",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina T Kolias, OTR
• Nik Kolicaj, MD
• Corey John Koll, PA-C
• Patricia Kolodziej, M.D.
• Jillian Kolster
• Ewa D Komorowska-Timek, MD
• Alexis Morgan Kompier, LMSW
• Quinn Konarska, MA, LMFT
• Loukas Nicholas Kondyles, LIMITED LICENSE COUN
• Donald Michael Konen, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.