Individual provider Active NPI

Sarah A Gwillim, LLMSW

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1275889453
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801094153 Issued in MI
Practice address
781 36TH St SE
Grand Rapids, MI 49508
Phone
(616) 248-5262
Fax
(616) 726-1883
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801094153 MI Primary
Case Manager/Care Coordinator 171M00000X 6801094153 MI

Addresses

Primary practice location

781 36TH St SE
Grand Rapids, MI 49508

Mailing address

PO Box 141
Grand Rapids, MI 49501-0141
Phone (616) 248-5262

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

LicenseStateTypeSpecialty
6801094153MIMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1275889453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 141",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495010141",
            "telephone_number": "616-248-5262",
            "fax_number": "616-726-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49508",
            "telephone_number": "616-248-5262",
            "fax_number": "616-726-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWILLIM",
        "first_name": "SARAH",
        "middle_name": "A",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094153",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "6801094153",
            "primary": false
        }
    ],
    "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 Jul 25, 2012; 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.