Active NPI
Frederick G Greaves, EDD
- Psychologist
- Kalamazoo, MI
National Provider Identifier
1306901103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301002583
- Practice address
- 4031 W Main
Kalamazoo, MI 49006 - Phone
- (269) 567-4202
- NPI assigned
- Dec 22, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301002583 | MI | Primary |
Addresses
Primary practice location
4031 W Main
Kalamazoo, MI 49006
Mailing address
250 Golfview
Plainwell, MI 49080
Phone (269) 664-5846
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68OC91218 | Other | MI | BLUE CROSS |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306901103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 GOLFVIEW",
"city": "PLAINWELL",
"state": "MI",
"postal_code": "49080",
"telephone_number": "269-664-5846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4031 W MAIN",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49006",
"telephone_number": "269-567-4202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREAVES",
"first_name": "FREDERICK",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "EDD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301002583",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "68OC91218",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.