Theresa Lynn Bundy-Pham

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801068956 Issued in MI

Practice address

1000 Parchment Dr SE
Grand Rapids, MI 49546

Phone

(616) 957-9112

Fax

(616) 957-2409

NPI assigned

Nov 23, 2009

Last updated

Jul 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychology Associates of Grand Rapids PCGroup PAC ID 6608826557, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychology Associates of Grand Rapids PC

  • Psychologist
  • Grand Rapids, MI
  • NPI 1205017738
  Medicare reassignment Care Compare group NPD
• Psychology Associates of Grand Rapids PC

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1073747648
  NPD
• Kent County CMH Authority

  dba Network 180

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1194617811
  NPD (past)
• Moka Corporation

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Muskegon, MI
  • NPI 1669538419
  NPD (past)
• Spectrum Community Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Westland, MI
  • NPI 1164577391
  NPD (past)
• Spectrum Community Services

  • Home Health Agency
  • Westland, MI
  • NPI 1457117962
  NPD (past)
• Thresholds Inc

  • Case Management Agency
  • Grand Rapids, MI
  • NPI 1154403467
  NPD (past)
• Wilson and Wynn Interventions, PLC

  • Intellectual & Developmental Disabilities Psychologist
  • Grand Rapids, MI
  • NPI 1598810137
  NPD (past)

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1679801179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-957-9112",
            "fax_number": "616-957-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PARCHMENT DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-957-9112",
            "fax_number": "616-957-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNDY-PHAM",
        "first_name": "THERESA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801068956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca L Bultman, MD
• Shayla Bunch
• Lenuta Bunda
• Nicholas Bunda, MD
• Brenten Bunde-Schau
• Anna Bundy
• Madisyn Eve Bunke
• Katherine Marie Bunnell, OTR/L
• Danielle Buno, LMSW, MPA
• Heather Bunting, MD

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.