Individual provider Active NPI

Reynelda A Jones, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1780997007
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801091230 Issued in MI
Practice address
5150 Northland Dr Ave NE
Inside the Remedy House
Grand Rapids, MI 49525
Phone
(616) 319-3863
Fax
(616) 588-6443
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 6801091230 MI Primary

Addresses

Primary practice location

5150 Northland Dr Ave NE
Inside the Remedy House
Grand Rapids, MI 49525

Mailing address

1234 Hall St SE
Grand Rapids, MI 49506-3274
Phone (616) 272-2577

Other practice location 1

320 Commerce Ave SW
Grand Rapids, MI 49503-4101
Phone (616) 258-7599

Other identifiers 1

IdentifierTypeStateIssuer
4483587MedicaidMI

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
I20130628000383 MI Practitioner - Clinical Social Worker 3072753839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
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
Pine Rest Christian Mental Health Services CurrentSince Apr 9, 2018 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Apr 9, 2018 Accepting new patients
Arbor Circle Corporation Clinical CurrentSince Jan 2, 2013 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

320 Commerce Ave SW
Grand Rapids, MI 49503
Phone (616) 222-4570

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

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": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1780997007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 HALL ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063274",
            "telephone_number": "616-272-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 NORTHLAND DR AVE NE",
            "address_2": "INSIDE THE REMEDY HOUSE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-319-3863",
            "fax_number": "616-588-6443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Commerce Ave SW",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034101",
            "country_code": "US",
            "telephone_number": "616-258-7599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "REYNELDA",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4483587",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.