NPIMap

Organization Active NPI

Center for Adolescent and Child Neurology

  • Neurology with Special Qualifications in Child Neurology Physician
  • Grand Rapids, MI
National Provider Identifier
1942620638
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
Legal business name
CENTER FOR ADOLESCENT AND CHILD NEUROLOGY
Practice address
422 Plymouth Ave NE
Grand Rapids, MI 49505-6028
Phone
(616) 294-0010
NPI assigned
Apr 21, 2014
Last updated
Feb 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Dr. Olufemi Oluseun Soyode, M.D.NPI 1184735698
Title
Owner
Phone
(616) 294-0010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X Primary

Addresses

Primary practice location

422 Plymouth Ave NE
Grand Rapids, MI 49505-6028

Mailing address

422 Plymouth Ave NE
Grand Rapids, MI 49505-6028
Phone (616) 294-0010

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14536/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1942620638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-294-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056028",
            "telephone_number": "616-294-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ADOLESCENT AND CHILD NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "SOYODE",
        "authorized_official_first_name": "OLUFEMI",
        "authorized_official_middle_name": "OLUSEUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-294-0010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "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 Feb 17, 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.

Verify at the official NPI Registry.