Baymark of Michigan, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

BAYMARK OF MICHIGAN, INC.

Practice address

5500 Division Avenue SE
Kentwood, MI 49548

Phone

(214) 379-3300

Fax

(214) 550-2635

NPI assigned

Apr 3, 2018

Organization subpart

No

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

Authorized official

Name

Bond Andrews

Title

VP, RCM

Phone

(214) 379-3379

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MedMark Kentwood Doing business as

Locations

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1871099481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 170",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576458",
            "telephone_number": "214-379-3300",
            "fax_number": "214-550-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 DIVISION AVENUE SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "49548",
            "telephone_number": "214-379-3300",
            "fax_number": "214-550-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYMARK OF MICHIGAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "BOND",
        "authorized_official_title_or_position": "VP, RCM",
        "authorized_official_telephone_number": "214-379-3379"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERT OF OCCUPANCY",
            "identifier": "OF18038936",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedMark Kentwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regina Bass
• Taylor Bateman
• Parlee Bates
• Adeline Bauer, OD
• Rajendra D Bavada, R.PH
• Adam Beadenkopf, P. T.
• Daniel Lee Bearley, D.D.S
• Vicki Lynn Beatty
• Claudia Maryann Beauvais
• Meghan Andrea Beeks Davis, LMSW

• Substance Use Disorder Rehabilitation Clinic/Center in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.

Verify at the official NPI Registry.