Gerard Remillard III

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703106060 Issued in MI

Practice address

890 N 10TH St
Kalamazoo, MI 49009-6192

Phone

(248) 460-3434

NPI assigned

Oct 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Beacon Specialized Living New Jersey, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Kalamazoo, MI
  • NPI 1013615269
  NPD

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1699492322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 N 10TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490096192",
            "telephone_number": "248-460-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 N 10TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490096192",
            "telephone_number": "248-460-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMILLARD",
        "first_name": "GERARD",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703106060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gerard.remillard@beaconspecialized.org",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Work Email",
            "address_1": "890 N 10th St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490096192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Reinert, OTR/L
• Robert W Reinhardt, M.D.
• Joel H Reinoehl, MD
• Emma Reist
• Kristen Reister
• Mark Joseph Remmler, PA-C
• Renaissance Rehabilitation Associates
• Renaissance Rehabilitation Associates PLLC
• Renaissance Rehabilitation Professionals LLC
• Renal Care Group Southwest Michigan, LLC

• Licensed Practical Nurse in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.