Individual provider Active NPI

Robert Baird, PH.D.

  • Clinical Psychologist
  • Grand Rapids, MI
National Provider Identifier
1932136165
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301012859 Issued in MI
Practice address
2851 Charlevoix Dr SE Ste 323
Grand Rapids, MI 49546-7092
Phone
(616) 458-0692
Fax
(616) 458-8129
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301012859 MI
Clinical Psychologist 103TC0700X 6301012859 MI Primary

Addresses

Primary practice location

2851 Charlevoix Dr SE Ste 323
Grand Rapids, MI 49546-7092

Mailing address

161 Ottawa Ave NW
Suite 300C
Grand Rapids, MI 49503-2700
Phone (616) 458-0692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080717000192 MI Practitioner - Clinical Psychologist 9638172364 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301012859MIMDPsychologist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1932136165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 OTTAWA AVE NW",
            "address_2": "SUITE 300C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032700",
            "telephone_number": "616-458-0692",
            "fax_number": "616-458-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 CHARLEVOIX DR SE STE 323",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467092",
            "telephone_number": "616-458-0692",
            "fax_number": "616-458-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRD",
        "first_name": "ROBERT",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012859",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.