Active NPI
Grace Boyle
- Clinical Social Worker
- Grand Rapids, MI
National Provider Identifier
1730565243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801100042
- Practice address
- 805 Leonard St NE
Grand Rapids, MI 49503-1138 - Phone
- (616) 451-2021
- NPI assigned
- Aug 6, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1203 | CO | |
| Clinical Social Worker | 1041C0700X | 6801100042 | MI | Primary |
Addresses
Primary practice location
805 Leonard St NE
Grand Rapids, MI 49503-1138
Mailing address
235 Calkins Ave SE # 1
Grand Rapids, MI 49506-1519
Phone (269) 352-3241
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1203 | CO | MD | Clinical Social Worker |
| 6801100042 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D a Blodgett-St Johns | Clinical | Past | Accepting new patients |
| D.a. Blodgett - St. John'S | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Grand Rapids, MI
- NPI 1801929435
-
- Community/Behavioral Health Agency
- Grand Rapids, MI
- NPI 1861701229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490659200000",
"number": "1730565243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 CALKINS AVE SE # 1",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495061519",
"telephone_number": "269-352-3241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 LEONARD ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031138",
"telephone_number": "616-451-2021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLE",
"first_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-06",
"last_updated": "2017-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "1203",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801100042",
"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 Mar 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.