Individual provider Active NPI

Anthony Kirvan

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1376326280
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851111153 Issued in MI
Practice address
1720 Plainfield Ave NE
Grand Rapids, MI 49505-4705
Phone
(214) 717-3953
NPI assigned
Aug 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6851111153 MI Primary

Addresses

Primary practice location

1720 Plainfield Ave NE
Grand Rapids, MI 49505-4705

Mailing address

8797 Flat Creek Dr Unit I
Rockford, MI 49341-8947
Phone (214) 717-3953

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
6851111153MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1376326280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8797 FLAT CREEK DR UNIT I",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418947",
            "telephone_number": "214-717-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 PLAINFIELD AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054705",
            "telephone_number": "214-717-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRVAN",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851111153",
            "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 Aug 15, 2023; 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.