Individual provider Active NPI

Gretchen Annie Layman, P.A.

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1932340080
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006709 Issued in MI
Practice address
4100 Lake Dr SE
Suite 300
Grand Rapids, MI 49546-8292
Phone
(616) 267-8860
Fax
(616) 267-8442
NPI assigned
Mar 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006709 MI Primary

Addresses

Primary practice location

4100 Lake Dr SE
Suite 300
Grand Rapids, MI 49546-8292

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601006709MIMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1932340080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE",
            "address_2": "SUITE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-267-8860",
            "fax_number": "616-267-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAYMAN",
        "first_name": "GRETCHEN",
        "middle_name": "ANNIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006709",
            "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 Mar 7, 2014; 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.