Active NPI
Bruce H Vermeer, PSY.D.
- Psychologist
- Wyoming, MI
National Provider Identifier
1477619997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301008623
- Practice address
- 2093 Health Dr SW
Suite 200
Wyoming, MI 49519-9691 - Phone
- (616) 742-1960
- Fax
- (616) 819-2222
- NPI assigned
- Dec 29, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 6301008623 | MI | |
| Psychologist | 103T00000X | 6301008623 | MI | Primary |
| Clinical Psychologist | 103TC0700X | 6301008623 | MI |
Addresses
Primary practice location
2093 Health Dr SW
Suite 200
Wyoming, MI 49519-9691
Mailing address
2093 Health Dr SW
Suite 200
Wyoming, MI 49519-9691
Phone (616) 742-1960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6301008623 | Other | MI | PSYCHOLOGIST LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008623 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Valley Medical Specialists PLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1033226402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318896000000",
"number": "1477619997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2093 HEALTH DR SW",
"address_2": "SUITE 200",
"city": "WYOMING",
"state": "MI",
"postal_code": "495199691",
"telephone_number": "616-742-1960",
"fax_number": "616-819-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2093 HEALTH DR SW",
"address_2": "SUITE 200",
"city": "WYOMING",
"state": "MI",
"postal_code": "495199691",
"telephone_number": "616-742-1960",
"fax_number": "616-819-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERMEER",
"first_name": "BRUCE",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2011-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MI",
"license": "6301008623",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301008623",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301008623",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST LICENSE",
"identifier": "6301008623",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.