Active NPI
Sydney Marie Gardella
- Behavior Technician
- Grand Rapids, MI
National Provider Identifier
1790240224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3361 36TH St SE
Grand Rapids, MI 49512-2809 - Phone
- (616) 248-2522
- NPI assigned
- Feb 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | MI | Primary |
Addresses
Primary practice location
3361 36TH St SE
Grand Rapids, MI 49512-2809
Mailing address
4279 S University Dr
Allendale, MI 49401-8920
Phone (517) 575-9198
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549584000000",
"number": "1790240224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4279 S UNIVERSITY DR",
"city": "ALLENDALE",
"state": "MI",
"postal_code": "494018920",
"telephone_number": "517-575-9198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3361 36TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495122809",
"telephone_number": "616-248-2522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDELLA",
"first_name": "SYDNEY",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-08",
"last_updated": "2019-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": null,
"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 Feb 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.