NPIMap

Organization Active NPI

D a Blodgett-St Johns

Doing business as D.A. Blodgett For Children

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1801929435
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CB410201088 Issued in MI
Legal business name
D A BLODGETT-ST JOHNS
Doing business as
D.A. Blodgett For Children
Practice address
2172 Dean Lake Ave NE
Grand Rapids, MI 49505-4444
Phone
(616) 451-2021
Fax
(616) 774-3842
NPI assigned
Mar 13, 2007
Last updated
Apr 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Authorized official

Name
Mrs. Tammy Smith
Title
Director of Finance
Phone
(616) 451-2021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X CB410201088 MI Primary

Addresses

Primary practice location

2172 Dean Lake Ave NE
Grand Rapids, MI 49505-4444

Mailing address

2172 Dean Lake Ave NE
Grand Rapids, MI 49505-4444
Phone (616) 451-2021

Other names 1

  • D.A. Blodgett For Children Doing business as

National Provider Directory

National Provider Directory

Locations

2172 Dean Lake Ave NE
Grand Rapids, MI 49505
Phone (616) 451-2021

Practitioners & affiliated clinicians

Practitioners 140

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 140

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1801929435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2172 DEAN LAKE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054444",
            "telephone_number": "616-451-2021",
            "fax_number": "616-774-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2172 DEAN LAKE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054444",
            "telephone_number": "616-451-2021",
            "fax_number": "616-774-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D A BLODGETT-ST JOHNS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "616-451-2021",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "CB410201088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D.A. Blodgett For Children",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "D.A. Blodgett For Children",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 26, 2023; 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.