FS GRAND RAPIDS SOUTH, LLC (NPI# 1003126400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003126400 |
| Entity Type | Organization |
| Organization Name | FS GRAND RAPIDS SOUTH, LLC |
| Practice Address |
6750 Kalamazoo Ave Se Suite E Grand Rapids MI 49508-7897 |
| Practice Telephone | 6166987200 |
| Practice Fax Number | 6166987212 |
| Mailing Telephone | 6166987200 |
| Mailing Fax Number | 6166987212 |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |
| Authorized Official Name | MR. ROBERT L SKINNER JR. (OWNER) |
| Authorized Official Telephone | 6166987200 |
| Authorized Official Credential | C. PED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 335E00000X | Prosthetic/Orthotic Supplier | CPED3429 | MI | Suppliers |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | CPED3413 | MI | Suppliers |
| Street Address |
6750 KALAMAZOO AVE SE SUITE E |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49508-7897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124210091 | Troy Jonathan Lebaron | Optometrist | 6750 Kalamazoo Ave Se, Grand Rapids, MI 49508-7897 | 2007-08-15 |
| 1467786822 | Professional Eyecare of West Michigan LLC | Optometrist | 6750 Kalamazoo Ave Se, Suite C, Grand Rapids, MI 49508-7897 | 2009-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012367 | Jenna Brianne Labrecque | Social Worker | 2013 East Castle Dr, Suite B, Kentwood, MI 49508 | 2020-10-27 |
| 1881208809 | Morgan Paige Ballmann | Physical Therapy Assistant | 4150 Kalamazoo Ave. Se, Grand Rapids, MI 49508 | 2020-09-08 |
| 1699385740 | Jodie Lynn Robertson | Prosthetist | 3720 Eastern Se, Grand Rapids, MI 49508 | 2020-08-04 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1255801833 | Ikeia Tynika Hill | Licensed Practical Nurse | 1627 Lotus, Grand Rapids, MI 49508 | 2018-11-27 |
| 1326556838 | Araceli Contreras-hernandez | Behavior Technician | 3566 Eastern Ave. Se, Kentwood, MI 49508 | 2018-01-18 |
| 1881102788 | A Grand Rapids Senior Social Exchange and Adult Day Center | In Home Supportive Care | 3212 Eastern Ave Se, Grand Rapids, MI 49508 | 2018-01-14 |
| 1952827107 | Nupoint Services LLC | Clinic/Center | 1620 44th Street Se, Grand Rapids, MI 49508 | 2017-08-19 |
| 1710427695 | Embracing Life Afc | Custodial Care Facility | 1405 Forrester St S.e., Grand Rapids, MI 49508 | 2017-02-27 |
| 1083162838 | Katherine Berenice Campoverde Arevalo | Technician, Other | 1157 Billigs Ct Se, Ap# 1a, Grand Rapids, MI 49508 | 2016-09-21 |
| Find all providers in zip 49508 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417460643 | Teter Orthotics & Prosthetics Inc | Prosthetic/Orthotic Supplier | 515 Michigan St Ne Ste 301, Grand Rapids, MI 49503-5721 | 2017-11-09 |
| 1205059615 | Messer Orthopedics LLC | Prosthetic/Orthotic Supplier | 4955 E Beltline Ave Ne, Suite C, Grand Rapids, MI 49525-1097 | 2007-04-11 |
| 1225078298 | Teter Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 4024 Park East Ct Se Ste B, Grand Rapids, MI 49546-8810 | 2006-06-07 |
| 1619929643 | Mary Free Bed Orthotics and Prosthetics | Prosthetic/Orthotic Supplier | 360 Lafayette Ave Se, Suite 320, Grand Rapids, MI 49503-4677 | 2006-05-17 |
| 1447230156 | Responsive Home Health Care Inc | Prosthetic/Orthotic Supplier | 1711 4 Mile Rd Ne, Grand Rapids, MI 49525-2440 | 2006-01-19 |
| 1154894046 | Laker Prosthetics | Prosthetic/Orthotic Supplier | 5181 Plainfield Ave Ne, Suite D, Grand Rapids, MI 49525 | 2019-01-03 |
| 1740532035 | Orthopaedic Associates of Grand Rapids PC | Prosthetic/Orthotic Supplier | 2680 Leonard St Ne, Grand Rapids, MI 49525 | 2012-10-10 |
| 1679839146 | Orthopaedic Associates of Grand Rapids, PC | Prosthetic/Orthotic Supplier | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2012-04-09 |
| 1972737286 | Orthopaedic Associates of Grand Rapids PC | Prosthetic/Orthotic Supplier | 230 Michigan St Ne, Grand Rapids, MI 49503-2550 | 2009-05-14 |
| 1629010731 | Gregory Fryling | Prosthetic/Orthotic Supplier | 230 Michigan St Ne, Ste 200, Grand Rapids, MI 49503-2550 | 2006-06-12 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49508 |
Please comment or provide details below to improve the information on FS GRAND RAPIDS SOUTH, LLC.
| 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.