Individual provider Active NPI

Mackenzie Jane Rohm

  • Nurse's Aide
  • Grand Rapids, MI
National Provider Identifier
1295667939
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
230013600420707 Issued in MI
Practice address
4218 Burton St SE
Grand Rapids, MI 49546-6121
Phone
(616) 301-8000
NPI assigned
May 29, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 230013600420707 MI Primary

Addresses

Primary practice location

4218 Burton St SE
Grand Rapids, MI 49546-6121

Mailing address

51 Mathews CT NE
Grand Rapids, MI 49505-4919
Phone (616) 291-2219

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
230013600420707MIMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1780012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1295667939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 MATHEWS CT NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054919",
            "telephone_number": "616-291-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4218 BURTON ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466121",
            "telephone_number": "616-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHM",
        "first_name": "MACKENZIE",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-29",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MI",
            "license": "230013600420707",
            "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 May 29, 2026; 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.