Individual provider Active NPI

Heidi Lynn Dygert, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1740604438
Registry record updated May 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801115587 Issued in MI
Practice address
3950 Sparks Dr SE Ste 103
Grand Rapids, MI 49546-6159
Phone
(616) 455-5000
NPI assigned
Feb 14, 2014
Last updated
May 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801096091 MI
Clinical Social Worker 1041C0700X 6801115587 MI Primary

Addresses

Primary practice location

3950 Sparks Dr SE Ste 103
Grand Rapids, MI 49546-6159

Mailing address

3950 Sparks Dr SE Ste 103
Grand Rapids, MI 49546-6159
Phone (517) 882-3732

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
I20240102003179 MI Practitioner - Clinical Social Worker 0840640934 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

3950 Sparks Dr SE
Suite 103
Grand Rapids, MI 49546-6159
Phone (517) 882-3732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801096091MIMDSocial Worker
6801115587MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Clinical CurrentSince Jun 7, 2024 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Jun 7, 2024 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Dec 15, 2023 Accepting new patients
Pine Rest Christian Mental Health Services Social Worker CurrentSince Dec 15, 2023 Accepting new patients

Locations

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

3950 Sparks Dr SE
Ste 103
Grand Rapids, MI 49546
Phone (616) 455-5000

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715472000000",
    "number": "1740604438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 SPARKS DR SE STE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466159",
            "telephone_number": "517-882-3732",
            "fax_number": "517-999-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 SPARKS DR SE STE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466159",
            "telephone_number": "616-455-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYGERT",
        "first_name": "HEIDI",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-14",
        "last_updated": "2024-05-12",
        "certification_date": "2024-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801096091",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.