SUBODH JAIN (NPI# 1033341888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033341888 |
| Entity Type | Individual |
| Full Name | SUBODH JAIN |
| Credential | MD |
| Practice Address |
2750 E Beltline Ave Ne Fl 3 Grand Rapids MI 49525-8614 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6164475820 |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2020-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
4301502237 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1235 E Cherokee St, Springfield, MO 658042203 | 4178202700 |
| Street Address |
2750 E BELTLINE AVE NE FL 3 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-8614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255388062 | John Visser | Psychiatry & Neurology | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525 | 2006-05-27 |
| 1730737537 | Kaitlyn Ashley Armstrong | Physician Assistant | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2019-08-27 |
| 1942860119 | Heshan Jude Fernando | Psychologist | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2019-06-19 |
| 1033698865 | Cynthia Marie Bailey | Nurse Practitioner | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2018-08-13 |
| 1609354489 | Tricia Maria Vanderbilt Luke | Nurse Practitioner | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2018-08-02 |
| 1144678020 | Alicia Beth Vanden Bussche Jantz | Clinical Neuropsychologist | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2016-06-01 |
| 1144684267 | Lindsay M Blair | Social Worker | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2016-04-06 |
| 1619358686 | Nicholas James Lannen | Psychiatry & Neurology | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2015-06-15 |
| 1346627916 | Justin Beuthin | Psychiatry & Neurology | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2015-05-02 |
| 1114304342 | Sarah Ellen Deleon | Psychiatry & Neurology | 2750 E Beltline Ave Ne Fl 3, Grand Rapids, MI 49525-8614 | 2015-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164712055 | Tatjana Maric | Psychiatry & Neurology | 420 Baltimore Dr Ne, Grand Rapids, MI 49503-3934 | 2011-04-12 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1245486919 | Josharon Mutchler, Md, Pllc | Psychiatry & Neurology | 2035 28th St Se, Suite P, Grand Rapids, MI 49508-1594 | 2008-08-14 |
| 1093911505 | Jennifer Bowden | Psychiatry & Neurology | 35 Michigan St Ne Ste 5201, Grand Rapids, MI 49503 | 2007-06-22 |
| 1265650667 | Elizabeth Kowal | Psychiatry & Neurology | 35 Michigan St Ne Ste 5201, Grand Rapids, MI 49503-2514 | 2007-04-23 |
| 1063575744 | Janice K Coates | Psychiatry & Neurology | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2006-12-18 |
| 1912081589 | Dhanashree Mahesh | Psychiatry & Neurology | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316376056 | Esmaeil Emami | Psychiatry & Neurology | 2955 Franklin Rd, Bloomfield Hills, MI 48302-0917 | 2013-11-04 |
| 1154760312 | Samantha Fugate Kennedy | Psychiatry & Neurology | 909 Fee Rd Ste B119, East Lansing, MI 48824 | 2013-06-21 |
| 1407199961 | David Donald Krohn | Psychiatry & Neurology | 563 Highland Park Dr, Traverse City, MI 49686-2863 | 2013-04-03 |
| 1972893824 | Katherine Barbara Krive | Psychiatry & Neurology | 801 S Waverly Rd Ste 100, Lansing, MI 48917-4200 | 2011-04-12 |
| 1295056653 | Veronica Yap Tan | Psychiatry & Neurology | 23354 Portage Way, Apt. 2212, Novi, MI 48375 | 2010-06-18 |
| 1548588874 | Katie Alanna Keller | Psychiatry & Neurology | 79 Alexandrine West, Detroit, MI 48201 | 2010-05-11 |
| 1538390133 | Behavioral Health Associates Pllc | Psychiatry & Neurology | 19500 Middlebelt Rd, Suite 350e, Livonia, MI 48152-2196 | 2009-07-30 |
| 1235375775 | Kristine Baker | Psychiatry & Neurology | 721 Cherokee St, Traverse City, MI 49684-1401 | 2009-01-06 |
| 1689820078 | Margaret Mary Casey | Psychiatry & Neurology | 1326 Saint Antoine St, Detroit, MI 48226-2301 | 2008-08-18 |
| 1992951693 | Saadia Nosheen | Psychiatry & Neurology | 4250 Plymouth Rd Spc 5766, University of Michigan, Department of Psychiatry, Ann Arbor, MI 48109-2700 | 2008-08-13 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
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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.