Individual provider Active NPI

Judith K Kuiper, PHD LLP

  • Clinical Psychologist
  • Grand Rapids, MI
National Provider Identifier
1740240704
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301009065 Issued in MI
Practice address
1870 Leonard NE
Grand Rapids, MI 49505
Phone
(616) 956-1122
Fax
(616) 956-8033
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301009065 MI Primary

Addresses

Primary practice location

1870 Leonard NE
Grand Rapids, MI 49505

Mailing address

PO Box 30516
Dept 6001a
Lansing, MI 48909-8016
Phone (616) 235-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070919000033 MI Practitioner - Clinical Psychologist 6800980061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7858 Darmon PL
Central Lake, MI 49622-9422
Phone (616) 581-4668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301009065MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kuiper Act, PLLC Clinical CurrentSince Feb 9, 2011 Accepting new patients

Locations

8106 W State St
Central Lake, MI 49622
Phone (231) 544-1277

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1740240704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 6001A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "616-235-2090",
            "fax_number": "616-235-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 LEONARD NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49505",
            "telephone_number": "616-956-1122",
            "fax_number": "616-956-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUIPER",
        "first_name": "JUDITH",
        "middle_name": "K",
        "credential": "PHD LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.