Individual provider Active NPI

Susanna Joy Rozema

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1780061168
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801083756 Issued in MI
Practice address
150 Jefferson Ave SE
Grand Rapids, MI 49503-4306
Phone
(616) 685-1431
Fax
(616) 685-1437
NPI assigned
May 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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 6801083756 MI Primary

Addresses

Primary practice location

150 Jefferson Ave SE
Grand Rapids, MI 49503-4306

Mailing address

150 Jefferson Ave SE
Grand Rapids, MI 49503-4306
Phone (616) 685-1431

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

LicenseStateTypeSpecialty
6801083756MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1780061168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034306",
            "telephone_number": "616-685-1431",
            "fax_number": "616-685-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034306",
            "telephone_number": "616-685-1431",
            "fax_number": "616-685-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZEMA",
        "first_name": "SUSANNA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801083756",
            "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, 2015; 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.