Active NPI
Bryan Joseph Nixon, LPC
- Professional Counselor
- Grand Rapids, MI
National Provider Identifier
1245569052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401012317
- Practice address
- 1870 Leonard St NE
Grand Rapids, MI 49505-5650 - Phone
- (616) 956-1122
- Fax
- (616) 956-8033
- NPI assigned
- Dec 8, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401012317 | MI | Primary |
Addresses
Primary practice location
1870 Leonard St NE
Grand Rapids, MI 49505-5650
Mailing address
PO Box 120125
Grand Rapids, MI 49528-0103
Phone (616) 956-1122
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401012317 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296432000000",
"number": "1245569052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 120125",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495280103",
"telephone_number": "616-956-1122",
"fax_number": "616-956-8033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1870 LEONARD ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495055650",
"telephone_number": "616-956-1122",
"fax_number": "616-956-8033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIXON",
"first_name": "BRYAN",
"middle_name": "JOSEPH",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-08",
"last_updated": "2011-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401012317",
"primary": true
}
],
"identifiers": [],
"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 Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.