Jordan Alexis Gregory

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6352000976 Issued in MI

Practice address

500 Cascade West Pkwy SE Ste 240
Grand Rapids, MI 49546-2166

Phone

(616) 591-9000

Fax

(616) 591-9060

NPI assigned

Apr 30, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Rapids Therapy Group, IncGroup PAC ID 8325551112, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grand Rapids Therapy Group Inc

  • Psychologist
  • Grand Rapids, MI
  • NPI 1295211076
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1457108318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CASCADE WEST PKWY SE STE 240",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462166",
            "telephone_number": "616-591-9000",
            "fax_number": "616-591-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CASCADE WEST PKWY SE STE 240",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462166",
            "telephone_number": "616-591-9000",
            "fax_number": "616-591-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "JORDAN",
        "middle_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6352000976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory a. Kuldanek P.C.
• Danielle Gregory
• Denise Deschaine Gregory, M.D.
• Dennis C Gregory, PAC
• Jared Gregory, PT,DPT
• Lauren Greifenberg
• Breanne K Greiner
• Kendra Lynn Greiner
• Megan Gremban
• Jessica Gren

• Clinical Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.