Individual provider Active NPI

Todd Allen Wormmeester, PHD

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1427078088
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6802080055 Issued in MI
Practice address
533 Clinton Ave NW
Grand Rapids, MI 49534-3515
Phone
(616) 340-6985
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

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
Clinical Social Worker 1041C0700X 6802080055 MI Primary

Addresses

Primary practice location

533 Clinton Ave NW
Grand Rapids, MI 49534-3515

Mailing address

533 Clinton Ave NW
Grand Rapids, MI 49534-3515
Phone (616) 340-6985

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6802080055MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427078088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 CLINTON AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495343515",
            "telephone_number": "616-340-6985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 CLINTON AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495343515",
            "telephone_number": "616-340-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMMEESTER",
        "first_name": "TODD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802080055",
            "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 8, 2007; 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.