Active NPI
Datasha Renee Chapman
- In Home Supportive Care Agency
- Grand Rapids, MI
National Provider Identifier
1396522017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 1015 Benjamin Ave SE
Grand Rapids, MI 49506-3222 - Phone
- (616) 634-1711
- NPI assigned
- Sep 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
1015 Benjamin Ave SE
Grand Rapids, MI 49506-3222
Mailing address
1015 Benjamin Ave SE
Grand Rapids, MI 49506-3222
Phone (616) 634-1711
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRC Enterprises LLC | In Home Supportive Care | Current | Accepting new patients |
Organizations & group practices 1
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": "1694649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694649600000",
"number": "1396522017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 BENJAMIN AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495063222",
"telephone_number": "616-634-1711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 BENJAMIN AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495063222",
"telephone_number": "616-634-1711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAPMAN",
"first_name": "DATASHA",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-14",
"last_updated": "2023-09-14",
"certification_date": "2023-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"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 Sep 14, 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.