NPIMap

Organization Active NPI

Grand Valley State University

  • Health Service Clinic/Center
  • Grand Rapids, MI
National Provider Identifier
1386043719
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
4704248959 Issued in MI
Legal business name
GRAND VALLEY STATE UNIVERSITY
Practice address
72 Sheldon Blvd SE
Grand Rapids, MI 49503-4234
Phone
(616) 988-8774
NPI assigned
Aug 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Authorized official

Name
Ann Sheehan, DNP, RN, CPNP
Title
Assistant Dean for Practice Kcon
Phone
(616) 988-8774

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 4704248959 MI
Health Service Clinic/Center 261QH0100X 4704248959 MI Primary

Addresses

Primary practice location

72 Sheldon Blvd SE
Grand Rapids, MI 49503-4234

Mailing address

72 Sheldon Blvd SE
Grand Rapids, MI 49503-4234
Phone (616) 988-8774

Other names 1

  • Grand Valley State University Family Health Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Grand Valley State University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1386043719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 SHELDON BLVD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034234",
            "telephone_number": "616-988-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 SHELDON BLVD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034234",
            "telephone_number": "616-988-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND VALLEY STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "SHEEHAN",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "ASSISTANT DEAN FOR PRACTICE KCON",
        "authorized_official_telephone_number": "616-988-8774",
        "authorized_official_credential": "DNP, RN, CPNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4704248959",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MI",
            "license": "4704248959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Valley State University Family Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 21, 2014; 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.