Kathleen Eppard

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5281 Clyde Park Ave SW
Wyoming, MI 49509-9506

Phone

(616) 719-4263

NPI assigned

Jan 29, 2021

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kent County CMH Authority

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1194617811
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 29, 2021.

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1891386124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 FOXGLOVE CT NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259529",
            "telephone_number": "517-643-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5281 CLYDE PARK AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099506",
            "telephone_number": "616-719-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPARD",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Ellis
• Gwennan Dael Engen, FNP-C
• Kajah Mone English
• Entropy Health, PLLC
• John Richard Epema, D.O.
• Matthew Aaron Erck, DO
• Spencer Patrick Erdman, MA-SLP
• Brett Christian Erickson, D.O.
• Inez Rubio Escareno III
• Jose Ricardo Escobar, LCSW

• All providers in Wyoming, MI
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.