Individual provider Active NPI

Lindsay Ann Gomez, LMSW

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1396239026
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801102425 Issued in MI
Practice address
1115 Ball Ave NE
Building B
Grand Rapids, MI 49505
Phone
(616) 456-7775
Fax
(616) 451-8779
NPI assigned
Jun 16, 2018
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 6801102425 MI Primary

Addresses

Primary practice location

1115 Ball Ave NE
Building B
Grand Rapids, MI 49505

Mailing address

1115 Ball Ave NE
Building B
Grand Rapids, MI 49505
Phone (616) 456-7775

Other names 1

  • Ms. Lindsay Ann Mengebier Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102425MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1396239026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "address_2": "BUILDING B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49505",
            "telephone_number": "616-456-7775",
            "fax_number": "616-451-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "address_2": "BUILDING B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49505",
            "telephone_number": "616-456-7775",
            "fax_number": "616-451-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "LINDSAY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-16",
        "last_updated": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801102425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "MENGEBIER",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "LMSW",
            "code": "1",
            "type": "Former 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 Nov 7, 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.