Jack Grenan

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

27777 Inkster Rd Ste 100
Farmington Hills, MI 48334

Phone

(248) 299-0030

NPI assigned

Jul 31, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1497163646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345326",
            "telephone_number": "248-299-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27777 INKSTER RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48334",
            "telephone_number": "248-299-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18119 Shady Ridge Ct Apt 14",
            "address_purpose": "LOCATION",
            "city": "Spring Lake",
            "state": "MI",
            "postal_code": "494569002",
            "country_code": "US",
            "telephone_number": "616-414-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRENAN",
        "first_name": "JACK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014679",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Greig
• Matthew Scott Greiner, LMSW
• Samantha Greives
• Abby Greiwe
• James Allen Grekin, D.O.
• Adam Grenon
• Desirae Gres
• Graycie Gresham
• Mahkiya Gresham
• Patrick Casey Gresham, M.D.

• Behavior Technician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.