Individual provider Active NPI

Robert J Wessel, B.S.

  • Behavior Technician
  • Grand Haven, MI
National Provider Identifier
1558841106
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
15086 Lakeshore Dr
Grand Haven, MI 49417-9350
Phone
(616) 405-8559
NPI assigned
Aug 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

15086 Lakeshore Dr
Grand Haven, MI 49417-9350

Mailing address

15086 Lakeshore Dr # DT
Grand Haven, MI 49417-9350
Phone (616) 405-8559

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
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
D.a. Blodgett - St. John'S Past Accepting new patients
D a Blodgett-St Johns PastSince Oct 10, 2015 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1558841106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15086 LAKESHORE DR # DT",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179350",
            "telephone_number": "616-405-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15086 LAKESHORE DR",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179350",
            "telephone_number": "616-405-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSEL",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "B.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-14",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.