Active NPI
Jeanne Marie Gratiot-Deans, MD
- Nephrology Physician
- Grand Rapids, MI
National Provider Identifier
1508951971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 4301054974
- Practice address
- 330 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1267 - Phone
- (616) 752-6235
- Fax
- (616) 752-6324
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 4301054974 | MI | Primary |
Addresses
Primary practice location
330 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1267
Mailing address
330 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1267
Phone (616) 752-6235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3116251 | Medicaid | MI |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301054974 | MI | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295308800000",
"number": "1508951971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 E BELTLINE AVE NE",
"address_2": "SUITE 100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495061267",
"telephone_number": "616-752-6235",
"fax_number": "616-752-6324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 E BELTLINE AVE NE",
"address_2": "SUITE 100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495061267",
"telephone_number": "616-752-6235",
"fax_number": "616-752-6324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRATIOT-DEANS",
"first_name": "JEANNE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MI",
"license": "4301054974",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3116251",
"state": "MI"
}
],
"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 Jan 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.