NPIMap

Organization Active NPI

Wedgwood Christian Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Rapids, MI
National Provider Identifier
1902997224
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WEDGWOOD CHRISTIAN SERVICES
Practice address
3300 36TH St SE
Grand Rapids, MI 49512
Phone
(616) 942-2110
Fax
(616) 942-0589
NPI assigned
Sep 28, 2006
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Dr. Daniel Troyce Gowdy
Title
Ceo
Phone
(616) 392-1873

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X CI410201226 MI
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X CI410201359 MI
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X CI410201082 MI
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X CICI410201003 MI
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X CI410201501 MI
Children's Substance Abuse Rehabilitation Facility 3245S0500X CI410201502 MI

Addresses

Primary practice location

3300 36TH St SE
Grand Rapids, MI 49512

Mailing address

3300 36TH St SE
Grand Rapids, MI 49512
Phone (616) 942-2110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040916000460 MI Part B Supplier - Clinic/Group Practice 6305813403 Receives reassigned benefits from 9 practitioners
Practice locations: Grand Rapids, MI; Muskegon, MI

National Provider Directory

National Provider Directory

Locations

1260 Ekhart St NE
Grand Rapids, MI 49503
Phone (616) 356-5202

12930 James St
Ste 120
Holland, MI 49424
Phone (616) 930-5004

3300 36th St SE
Kentwood, MI 49512
Phone (616) 942-7294

3351 36th St SE
Kentwood, MI 49512
Phone (616) 831-5644

950 W Norton Ave
Ste 301
Muskegon, MI 49441
Phone (616) 831-5641

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1902997224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49512",
            "telephone_number": "616-942-2110",
            "fax_number": "616-942-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49512",
            "telephone_number": "616-942-2110",
            "fax_number": "616-942-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEDGWOOD CHRISTIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2026-09-21",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "GOWDY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "TROYCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-392-1873",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MI",
            "license": "CI410201226",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MI",
            "license": "CI410201359",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MI",
            "license": "CI410201082",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MI",
            "license": "CICI410201003",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MI",
            "license": "CI410201501",
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "MI",
            "license": "CI410201502",
            "primary": false
        }
    ],
    "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 21, 2026; 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.