BAYMARK OF MICHIGAN, INC. (NPI# 1871099481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871099481 |
| Entity Type | Organization |
| Organization Name | BAYMARK OF MICHIGAN, INC. |
| Other Organization Name | MEDMARK KENTWOOD |
| Practice Address |
5500 Division Avenue Se Kentwood MI 49548 |
| Mailing Address |
1720 Lakepointe Dr Ste 170 Lewisville TX 75057-6458 |
| Practice Telephone | 2143793300 |
| Practice Fax Number | 2145502635 |
| Mailing Telephone | 2143793300 |
| Mailing Fax Number | 2145502635 |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2019-02-20 |
| Authorized Official Name | BOND ANDREWS (VP, RCM) |
| Authorized Official Telephone | 2143793379 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | CERT OF OCCUPANCY | OF18038936 | 01 |
| Other Name | Type Code |
|---|---|
| MedMark Kentwood | Doing Business As Name - Organization |
| Street Address |
5500 DIVISION AVENUE SE |
| City | KENTWOOD |
| State | MI |
| Zip Code | 49548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205319811 | Pooja Patel | Social Worker | Spectrum Community Services, 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2018-09-10 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1629507801 | Laura Marie Quennoz | Psychiatry & Neurology | Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 | 2017-06-09 |
| 1821548504 | Alison Anderson | Technician, Other | 103 Roth St Se, Grand Rapids, MI 49548 | 2016-10-06 |
| 1831540152 | Jesse Aubil | Counselor | 264 Montebello St. Se 49548, Grand Rapids, MI 49548 | 2016-06-28 |
| 1306237920 | Sarah Benton | Social Worker | 225 Colrain St Sw, 2, Grand Rapids, MI 49548 | 2015-02-18 |
| 1578996856 | Karen Marie Irving | Social Worker | 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2013-08-09 |
| 1740348044 | Robert Kenneth Richmond | Preventive Medicine | 551 36th Street. Se, Wyoming, MI 49548 | 2006-12-05 |
| 1386738953 | Sharita Montiez Hall | Social Worker | 300 68th Street Se, Grand Rapids, MI 49548 | 2006-10-03 |
| 1255432977 | Rodney Ray Senneker | Podiatrist | 6703 S Division Ave, Grand Rapids, MI 49548 | 2006-09-26 |
| Find all providers in zip 49548 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1679714083 | Great Lakes Recovery Centers, Inc. | Clinic/Center | 1401 N. 26th Street, Suite 109, Escanaba, MI 49801 | 2009-03-13 |
| 1962606632 | St Johns Home | Clinic/Center | 2355 Knapp St Ne, Grand Rapids, MI 49505-4415 | 2007-06-14 |
| 1699981498 | West Michigan Therapy Inc | Clinic/Center | 130 E Apple Ave, Muskegon, MI 49442-3405 | 2007-05-16 |
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| Find all providers with the same taxonomy | ||||
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| 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.