Individual provider Active NPI

Jenalexis Cruz

  • Technician/Technologist
  • Grand Rapids, MI
National Provider Identifier
1720617665
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Technician/TechnologistTaxonomy code 156F00000X
Practice address
346 68TH St SW
Grand Rapids, MI 49548-7179
Phone
(616) 369-2850
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X
Technician/Technologist 156F00000X Primary

Addresses

Primary practice location

346 68TH St SW
Grand Rapids, MI 49548-7179

Mailing address

346 68TH St SW
Grand Rapids, MI 49548-7179
Phone (616) 369-2850

Other practice location 1

1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Phone (616) 464-0255

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1720617665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 68TH ST SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495487179",
            "telephone_number": "616-369-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 68TH ST SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495487179",
            "telephone_number": "616-369-2850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 E Beltline Ave SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495064336",
            "country_code": "US",
            "telephone_number": "616-464-0255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "JENALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "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 May 5, 2021; 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.