Active NPI
Caitlin Quantock
- Clinical Social Worker
- Grand Rapids, MI
National Provider Identifier
1558968982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801109805
- Practice address
- 1939 S Division Ave
Grand Rapids, MI 49507 - Phone
- (616) 247-3815
- NPI assigned
- Oct 8, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 6801109805 | MI | Primary |
Addresses
Primary practice location
1939 S Division Ave
Grand Rapids, MI 49507
Mailing address
1939 S Division Ave
Grand Rapids, MI 49507
Phone (616) 247-3815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801109805 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624579200000",
"number": "1558968982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1939 S DIVISION AVE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49507",
"telephone_number": "616-247-3815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1939 S DIVISION AVE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49507",
"telephone_number": "616-247-3815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUANTOCK",
"first_name": "CAITLIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-08",
"last_updated": "2021-06-25",
"certification_date": "2021-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801109805",
"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 Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.