Active NPI
Rebekah Gentry
- Counselor
- Grand Rapids, MI
National Provider Identifier
1790426112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6451022119
- Practice address
- 662 Deming St SE
Grand Rapids, MI 49507-3206 - Phone
- (616) 799-1712
- NPI assigned
- Apr 7, 2022
- Last updated
- Apr 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6451022119 | MI | Primary |
Addresses
Primary practice location
662 Deming St SE
Grand Rapids, MI 49507-3206
Mailing address
662 Deming St SE
Grand Rapids, MI 49507-3206
Phone (616) 799-1712
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
12511 152ND Ave
Grand Haven, MI 49417-8527
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6451022119 | MI | MD | Counselor |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Grand Haven, MI
- NPI 1922306323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1790426112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "662 DEMING ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495073206",
"telephone_number": "616-799-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "662 DEMING ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495073206",
"telephone_number": "616-799-1712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTRY",
"first_name": "REBEKAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-07",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6451022119",
"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 Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.