Individual provider Active NPI

Korin Wilson, LMSW

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1750938916
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1115 Ball Ave NE
Grand Rapids, MI 49505-5904
Phone
(616) 456-6571
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1115 Ball Ave NE
Grand Rapids, MI 49505-5904

Mailing address

239 Henry St
Coopersville, MI 49404-1141

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
I20241226002190 MI Practitioner - Clinical Social Worker 5698202935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arbor Circle CorporationGroup PAC ID 2668362393, 18 clinicians

Practice addresses (Care Compare)

1115 Ball Ave NE
Grand Rapids, MI 49505-5904
Phone (616) 459-7215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Circle Corporation CurrentSince Dec 1, 2024 Accepting new patients
Arbor Circle Corporation Past Accepting new patients

Locations

1101 Ball Ave NE
Grand Rapids, MI 49505
Phone (616) 456-7775

1115 Ball Ave NE
Grand Rapids, MI 49505
Phone (616) 451-3001

Organizations & group practices 3

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": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1750938916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 HENRY ST",
            "city": "COOPERSVILLE",
            "state": "MI",
            "postal_code": "494041141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055904",
            "telephone_number": "616-456-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KORIN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.