Brian Lafata

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

5351017790 Issued in MI

Practice address

100 Cherry St SE
Grand Rapids, MI 49503-4526

Phone

(616) 965-8200

NPI assigned

May 20, 2025

Last updated

May 20, 2025By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1235921891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3377 E FREE SOIL RD",
            "city": "FREE SOIL",
            "state": "MI",
            "postal_code": "494119604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHERRY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034526",
            "telephone_number": "616-965-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFATA",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5351017790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Ladd
• Elizabeth Louise Ladd
• Derek Anthony Lado, DO
• Grace Patricia Ladouceur, BA
• Douglas Eugene Ladue III, D.D.S
• Aubrey Lafave, COTA/L
• Jordan Lafave, D.O.
• Margaux Lafave, LMSW
• Laurie Lafeldt, OTR
• Tammy Lafey, LMSW

• Student in an Organized Health Care Education/Training Program in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.