Active NPI
Jacob Andrew Stillson
- Behavior Analyst
- Grand Rapids, MI
National Provider Identifier
1477034841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 7401001568
- Practice address
- 600 3 Mile Rd NW
Suite 200
Grand Rapids, MI 49544-1691 - Phone
- (616) 469-3870
- NPI assigned
- Aug 23, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 7401001568 | MI | Primary |
Addresses
Primary practice location
600 3 Mile Rd NW
Suite 200
Grand Rapids, MI 49544-1691
Mailing address
2738 Ardmore St SE
Grand Rapids, MI 49506-4919
Phone (231) 286-4528
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 |
|---|---|---|---|
| 7401001568 | MI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775174400000",
"number": "1477034841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2738 ARDMORE ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064919",
"telephone_number": "231-286-4528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 3 MILE RD NW",
"address_2": "SUITE 200",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495441691",
"telephone_number": "616-469-3870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILLSON",
"first_name": "JACOB",
"middle_name": "ANDREW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-23",
"last_updated": "2026-04-03",
"certification_date": "2026-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "7401001568",
"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 Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.