Active NPI
Kristine Ranae Patterson, LLMSW
- Clinical Social Worker
- Grand Rapids, MI
National Provider Identifier
1831449768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801094925
- Practice address
- 40 Jefferson Ave SE
Grand Rapids, MI 49503-4304 - Phone
- (616) 456-1443
- Fax
- (616) 732-6392
- NPI assigned
- Sep 18, 2012
- Last updated
- Sep 18, 2012
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801094925 | MI | Primary |
Addresses
Primary practice location
40 Jefferson Ave SE
Grand Rapids, MI 49503-4304
Mailing address
40 Jefferson Ave SE
Grand Rapids, MI 49503-4304
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801094925 | MI | MD | Clinical Social Worker |
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.
-
dba Catholic Social Services
- Clinical Social Worker
- Grand Rapids, MI
- NPI 1245303809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347926400000",
"number": "1831449768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 JEFFERSON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 JEFFERSON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034304",
"telephone_number": "616-456-1443",
"fax_number": "616-732-6392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "KRISTINE",
"middle_name": "RANAE",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-18",
"last_updated": "2012-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801094925",
"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 Sep 18, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.