Nxgen MDX, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NXGEN MDX, LLC

Practice address

801 Broadway Ave NW
Suite 203
Grand Rapids, MI 49504-4462

Phone

(855) 776-9436

Fax

(616) 710-4667

NPI assigned

May 15, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Alan Mack

Title

President/Ceo

Phone

(847) 343-0402

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Nxgen MDX LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nxgen MDX, LLC

  • Genetics Clinic/Center
  • Grand Rapids, MI
  • NPI 1447022819
  NPD tax ID

Locations

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1326484569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72512",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441920002",
            "telephone_number": "855-776-9436",
            "fax_number": "616-710-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY AVE NW",
            "address_2": "SUITE 203",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044462",
            "telephone_number": "855-776-9436",
            "fax_number": "616-710-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NXGEN MDX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "847-343-0402",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christie Lynn Nutkins, PHD, BCBA-D
• Nicole Nutt
• Alexandra Anne Nuttall
• NW Orthodontics PLLC
• Lequa Nwaohu
• Nxgen MDX, LLC
• Patience Mpulubusi Nyambe, FNP BC
• Bellah Nyamoga
• Sara E Nychypor, RD
• Lila Sue Nydam, BA

• Clinical Medical Laboratory in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.