Organization Active NPI

Reineke Consulting, LLC

  • Clinical Neuropsychologist
  • Grand Rapids, MI
National Provider Identifier
1952780686
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301009314 Issued in MI
Legal business name
REINEKE CONSULTING, LLC
Practice address
2020 Raybrook St SE Ste 308
Grand Rapids, MI 49546-7717
Phone
(616) 649-1010
Fax
(616) 551-2895
NPI assigned
May 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Dr. Lori Reineke, PH.D.NPI 1790765170
Title
President
Phone
(616) 649-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 6301009314 MI Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 6301009314 MI

Addresses

Primary practice location

2020 Raybrook St SE Ste 308
Grand Rapids, MI 49546-7717

Mailing address

2020 Raybrook St SE Ste 308
Grand Rapids, MI 49546-7717
Phone (616) 649-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151030001331 MI Part B Supplier - Clinic/Group Practice 4486964632 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1952780686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 RAYBROOK ST SE STE 308",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467717",
            "telephone_number": "616-649-1010",
            "fax_number": "616-551-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RAYBROOK ST SE STE 308",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467717",
            "telephone_number": "616-649-1010",
            "fax_number": "616-551-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REINEKE CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "REINEKE",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-649-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301009314",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009314",
            "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 Apr 21, 2023; 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.