Individual provider Active NPI

Michael Jack Reiffer, LMSW

  • Clinical Social Worker
  • Caledonia, MI
National Provider Identifier
1992984058
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801086312 Issued in MI
Practice address
9090 S Rodgers CT SE
Suite D
Caledonia, MI 49316-8052
Phone
(616) 891-8770
NPI assigned
Oct 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801086312 MI Primary

Addresses

Primary practice location

9090 S Rodgers CT SE
Suite D
Caledonia, MI 49316-8052

Mailing address

9090 S Rodgers CT SE
Suite D
Caledonia, MI 49316-8052
Phone (616) 891-8770

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
I20080516000461 MI Practitioner - Clinical Social Worker 9436228442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pine Rest Christian Mental Health ServicesGroup PAC ID 4981506508, 354 clinicians

Practice addresses (Care Compare)

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

4211 Pkwy Place Dr SW
Grandville, MI 49418-2695
Phone (616) 222-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services CurrentSince Apr 14, 2008 Accepting new patients
Pine Rest Christian Mental Health Services CurrentSince Apr 14, 2008 Accepting new patients

Locations

9090 S Rodgers Ct SE
Ste D
Caledonia, MI 49316

6505 Cherry Meadow Dr SE
Caledonia, MI 49316
Phone (616) 644-0787

4211 Parkway Place Dr SW
Grandville, MI 49418
Phone (616) 222-3700

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

4211 Parkway Place Dr SW
Ste 100
Wyoming, MI 49418
Phone (616) 222-3700

Organizations & group practices 2

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": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1992984058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9090 S RODGERS CT SE",
            "address_2": "SUITE D",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168052",
            "telephone_number": "616-891-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9090 S RODGERS CT SE",
            "address_2": "SUITE D",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168052",
            "telephone_number": "616-891-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIFFER",
        "first_name": "MICHAEL",
        "middle_name": "JACK",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-25",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caledonia, MI

Sources for this page

Verify at the official NPI Registry.