Individual provider Active NPI

Sharita Montiez Hall, LMSW

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1386738953
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801079796 Issued in MI
Practice address
300 68TH Street SE
Grand Rapids, MI 49548
Phone
(616) 455-5000
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801079796 MI Primary

Addresses

Primary practice location

300 68TH Street SE
Grand Rapids, MI 49548

Mailing address

300 68TH Street SE
Grand Rapids, MI 49548
Phone (616) 455-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050803000360 MI Practitioner - Clinical Social Worker 8426086117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

17325 Van Wagoner Rd
Spring Lake, MI 49456-9702
Phone (616) 847-5145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801079796MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services CurrentSince Aug 20, 2012 Accepting new patients
Pine Rest Christian Mental Health Services Social Worker CurrentSince Aug 20, 2012 Accepting new patients

Locations

17325 Van Wagoner Rd
Spring Lake, MI 49456
Phone (616) 846-9100

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386738953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH STREET SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49548",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH STREET SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49548",
            "telephone_number": "616-455-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SHARITA",
        "middle_name": "MONTIEZ",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801079796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.