Active NPI
Madison Renee Knowlton, LLMSW
- Clinical Social Worker
- Jenison, MI
National Provider Identifier
1326746496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1346 Baldwin St
Jenison, MI 49428-8937 - Phone
- (616) 765-8585
- NPI assigned
- Feb 20, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MI | Primary |
Addresses
Primary practice location
1346 Baldwin St
Jenison, MI 49428-8937
Mailing address
428 Bayberry Pointe Dr NW Apt F
Grand Rapids, MI 49534-4643
Phone (760) 884-7539
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tahoma Enterprises LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1326746496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "428 BAYBERRY POINTE DR NW APT F",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495344643",
"telephone_number": "760-884-7539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1346 BALDWIN ST",
"city": "JENISON",
"state": "MI",
"postal_code": "494288937",
"telephone_number": "616-765-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOWLTON",
"first_name": "MADISON",
"middle_name": "RENEE",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-20",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jenison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.