Active NPI
Kyle Brandon Avery
- Student in an Organized Health Care Education/Training Program
- Grand Rapids, MI
National Provider Identifier
1942858048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 223 Prospect Ave NE
Grand Rapids, MI 49503-5649 - Phone
- (231) 883-5818
- NPI assigned
- Sep 1, 2019
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
223 Prospect Ave NE
Grand Rapids, MI 49503-5649
Mailing address
223 Prospect Ave NE
Grand Rapids, MI 49503-5649
Phone (231) 883-5818
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567296000000",
"number": "1942858048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 PROSPECT AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035649",
"telephone_number": "231-883-5818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 PROSPECT AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035649",
"telephone_number": "231-883-5818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "KYLE",
"middle_name": "BRANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-01",
"last_updated": "2019-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"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 Sep 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.