Active NPI
Jacob John Robbins
- School Psychologist
- Grand Rapids, MI
National Provider Identifier
1407531015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- PP0000001079250
- Practice address
- 1250 Sigsbee St SE
Grand Rapids, MI 49506-2556 - Phone
- (616) 456-3696
- NPI assigned
- Jun 20, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | PP0000001079250 | MI | Primary |
Addresses
Primary practice location
1250 Sigsbee St SE
Grand Rapids, MI 49506-2556
Mailing address
1250 Sigsbee St SE
Grand Rapids, MI 49506-2556
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
| License | State | Type | Specialty |
|---|---|---|---|
| PP0000001079250 | MI | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1407531015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 SIGSBEE ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495062556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 SIGSBEE ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495062556",
"telephone_number": "616-456-3696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBBINS",
"first_name": "JACOB",
"middle_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-20",
"last_updated": "2023-06-20",
"certification_date": "2023-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MI",
"license": "PP0000001079250",
"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 Jun 20, 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.