Individual provider Active NPI

Briana Zoe Davids

  • Adult Care Home Facility
  • Kentwood, MI
National Provider Identifier
1326817321
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Practice address
415 Andover St SE
Kentwood, MI 49548-7674
Phone
(616) 717-2899
Fax
(616) 608-3713
NPI assigned
Jan 1, 2024
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X NU Primary

Addresses

Primary practice location

415 Andover St SE
Kentwood, MI 49548-7674

Mailing address

4958 Fuller Ave SE
Kentwood, MI 49508-4740
Phone (616) 717-2899

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

NPI Registry JSON

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

{
    "created_epoch": "1704067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1326817321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4958 FULLER AVE SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495084740",
            "telephone_number": "616-717-2899",
            "fax_number": "616-608-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ANDOVER ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495487674",
            "telephone_number": "616-717-2899",
            "fax_number": "616-608-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDS",
        "first_name": "BRIANA",
        "middle_name": "ZOE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-01",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.

Verify at the official NPI Registry.