Active NPI
Yuvonne Frederick
- Skilled Nursing Facility
- Grand Rapids, MI
National Provider Identifier
1417849043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Practice address
- 1146 Houseman Ave NE
Grand Rapids, MI 49503-1230 - Phone
- (517) 740-2171
- NPI assigned
- Jul 17, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | MI | Primary |
Addresses
Primary practice location
1146 Houseman Ave NE
Grand Rapids, MI 49503-1230
Mailing address
1146 Houseman Ave NE
Grand Rapids, MI 49503-1230
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1417849043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1146 HOUSEMAN AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1146 HOUSEMAN AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031230",
"telephone_number": "517-740-2171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "YUVONNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-17",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MI",
"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 Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.