Organization Active NPI

Kuiper Act, PLLC

  • Clinical Psychologist
  • Grand Rapids, MI
National Provider Identifier
1891091195
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301012952 Issued in MI
Legal business name
KUIPER ACT, PLLC
Practice address
4829 E Beltline Ave NE
BLDG 1 Suite 100
Grand Rapids, MI 49525-9747
Phone
(616) 581-4668
Fax
(866) 379-2151
NPI assigned
Feb 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Judith K Kuiper, PHDNPI 1740240704
Title
Provider
Phone
(616) 581-4668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301012952 MI Primary

Addresses

Primary practice location

4829 E Beltline Ave NE
BLDG 1 Suite 100
Grand Rapids, MI 49525-9747

Mailing address

4829 E Beltline Ave NE
BLDG 1 Suite 100
Grand Rapids, MI 49525-9747
Phone (616) 581-4668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110518000103 MI Part B Supplier - Clinic/Group Practice 1850577339 Receives reassigned benefits from 1 practitioner
Practice locations: Central Lake, MI

National Provider Directory

National Provider Directory

Locations

225 N Bridge St
#B
Bellaire, MI 49615
Phone (616) 581-4668

8106 W State St
Central Lake, MI 49622
Phone (231) 544-1277

4829 E Beltline Ave NE
#100
Grand Rapids, MI 49525
Phone (616) 364-3301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1891091195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE",
            "address_2": "BLDG 1 SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259747",
            "telephone_number": "616-581-4668",
            "fax_number": "866-379-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE",
            "address_2": "BLDG 1 SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259747",
            "telephone_number": "616-581-4668",
            "fax_number": "866-379-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUIPER ACT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-03",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "KUIPER",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "616-581-4668",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012952",
            "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 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.