JOANN SOUTHERN (NPI# 1578847612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578847612 |
| Entity Type | Individual |
| Full Name | JOANN SOUTHERN |
| Credential | 2705001197 |
| Practice Address |
2893 28th St Se Grand Rapids MI 49512-1622 |
| Practice Telephone | 6162411216 |
| Mailing Telephone | 6162411216 |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 2705001197 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2893 28TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49512-1622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757071 | St. Lukes Primary Care | Family Medicine | 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 | 2018-07-27 |
| 1013493733 | Pharmascript of Michigan Gr LLC | Pharmacy | 2661 29th St. Se Suite A, Grand Rapids, MI 49512 | 2018-07-16 |
| 1245736040 | Cassandra Slater | Technician, Other | 2925 Breton Rd Se, Grand Rapids, MI 49512 | 2018-04-02 |
| 1235632704 | John Mitchell Tanja | Occupational Therapist | 3350 Broadmoor Avenue Se, Grand Rapids, MI 49512 | 2018-03-12 |
| 1952829855 | Sarah Harlow | Physical Therapist | 2951 44th St Se, Kentwood, MI 49512 | 2017-08-31 |
| 1194248815 | Melinda Huizenga | Registered Nurse | 5300 Patterson Ave Se Ste 125, Grand Rapids, MI 49512 | 2017-07-25 |
| 1659812931 | Frantzie Pierre | Counselor | 3300 S Creek Dr Se Apt 201, Kentwood, MI 49512 | 2017-03-20 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1518282631 | Melanie Anne Hogeterp | Social Worker | 3180 East Paris Se, Kentwood, MI 49512 | 2010-03-31 |
| 1013147495 | Ardean Beth Brock-vanderwall | Counselor | 2828 Kraft Ave., Grand Rapids, MI 49512 | 2009-07-20 |
| Find all providers in zip 49512 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295348092 | Michael Allen Vaneerden | Massage Therapist | 1359 Emerald Ave Ne, Grand Rapids, MI 49505-5226 | 2020-08-31 |
| 1972113983 | Mary Beth Holtz | Massage Therapist | 3355 Eagle Park Dr Ne Ste 107, Grand Rapids, MI 49525-7004 | 2020-08-04 |
| 1689282824 | Annemarie Hazzard-pryor | Massage Therapist | 2050 Breton Rd Se Ste 109, Grand Rapids, MI 49546-5547 | 2020-07-14 |
| 1699308890 | Brenda Kay Purchase | Massage Therapist | 5300 Northland Dr Ne Ste F, Grand Rapids, MI 49525-1058 | 2020-02-16 |
| 1023586542 | Kayla Lynne Pettit | Massage Therapist | 435 Cherry St Se # B, Grand Rapids, MI 49503-4672 | 2018-11-02 |
| 1881160422 | Erica Kate Snay | Massage Therapist | 435 Cherry St Se Ste B, Grand Rapids, MI 49503-4672 | 2018-10-22 |
| 1720515406 | Tiffanie Ryder | Massage Therapist | 1110 Merrified St, Grand Rapids, MI 49507 | 2017-05-12 |
| 1902359706 | Cynthia Marie Thorson | Massage Therapist | 2184 Saginaw Rd Se, Grand Rapids, MI 49506-5446 | 2016-07-27 |
| 1316391477 | Kylin Mary-elizabeth Cronkhite | Massage Therapist | 710 Morris Ave Se, Apt #1, Grand Rapids, MI 49503-5324 | 2016-04-14 |
| 1992164180 | Sarita Gibbons | Massage Therapist | 1057 Bridge St Nw, Grand Rapids, MI 49504-5061 | 2016-02-16 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49512 |
Please comment or provide details below to improve the information on JOANN SOUTHERN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.