NPIMap

Organization Active NPI

Grand Valley State University

  • Student in an Organized Health Care Education/Training Program
  • Allendale, MI
National Provider Identifier
1689064610
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Legal business name
GRAND VALLEY STATE UNIVERSITY
Practice address
1 Campus Dr
Allendale, MI 49401-9401
Phone
(616) 331-5000
NPI assigned
Jan 29, 2015
Last updated
Jan 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Authorized official

Name
Dr. Brain Hatzel
Title
Associate Professor
Phone
(616) 331-8538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1 Campus Dr
Allendale, MI 49401-9401

Mailing address

4932 W Campus Dr
Unit B14
Allendale, MI 49401-8822

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2205591Grand Valley State University1 Campus Drive, Allendale, MI 49401Certificate of waiverDec 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
Grand Valley State University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422489600000",
    "number": "1689064610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4932 W CAMPUS DR",
            "address_2": "UNIT B14",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CAMPUS DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019401",
            "telephone_number": "616-331-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND VALLEY STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A",
        "authorized_official_last_name": "HATZEL",
        "authorized_official_first_name": "BRAIN",
        "authorized_official_title_or_position": "ASSOCIATE PROFESSOR",
        "authorized_official_telephone_number": "616-331-8538",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allendale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.