Active NPI
John Woods
- Psychologist
- Grand Rapids, MI
National Provider Identifier
1902293947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- CC-AABHX0365757
- Practice address
- 2505 Ardmore St SE
Grand Rapids, MI 49506-4924 - Phone
- (616) 559-1054
- NPI assigned
- Apr 16, 2015
- Last updated
- Apr 16, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | CC-AABHX0365757 | MI | Primary |
Addresses
Primary practice location
2505 Ardmore St SE
Grand Rapids, MI 49506-4924
Mailing address
2505 Ardmore St SE
Grand Rapids, MI 49506-4924
Phone (616) 559-1054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC-AABHX0365757 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Therapy Center Inc | Psychologist | Past | Accepting new patients |
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.
-
- Voluntary or Charitable Agency
- Grand Rapids, MI
- NPI 1073658597
Psychologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429142400000",
"number": "1902293947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 ARDMORE ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064924",
"telephone_number": "616-559-1054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2505 ARDMORE ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064924",
"telephone_number": "616-559-1054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-16",
"last_updated": "2015-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "CC-AABHX0365757",
"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 Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.