Active NPI
Scott Joseph Fletcher
- Community Health Worker
- Grand Rapids, MI
National Provider Identifier
1699022335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336 - Phone
- (616) 940-0040
- NPI assigned
- Aug 13, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Mailing address
11640 Shaner Ave NE
Cedar Springs, MI 49319-8553
Phone (616) 940-0040
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1699022335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11640 SHANER AVE NE",
"city": "CEDAR SPRINGS",
"state": "MI",
"postal_code": "493198553",
"telephone_number": "616-940-0040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1490 E BELTLINE AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064336",
"telephone_number": "616-940-0040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "SCOTT",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-13",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"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 Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.