AUDREY JAGT (NPI# 1154679348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154679348 |
| Entity Type | Individual |
| Full Name | AUDREY JAGT |
| Practice Address |
1490 E Beltline Ave Se Grand Rapids MI 49506-4336 |
| Mailing Address |
3525 Pratt Lake Ave Se Lowell MI 49331-9376 |
| Practice Telephone | 6169400040 |
| Mailing Telephone | 6164467085 |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2012-08-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1490 E BELTLINE AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49506-4336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528043544 | Hope Network - Rehabilitation Services | Psychologist | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2005-12-13 |
| 1447859343 | Dianee Green | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-10-21 |
| 1104425198 | Hans Jacob Stimac | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-10-20 |
| 1346848835 | Katherine D Westfall | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-10-15 |
| 1518564806 | Lisa Merkiel | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-10-08 |
| 1578178919 | Kevin Guggemos | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-09-12 |
| 1053926998 | Amber Kay Mcglynn | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-09-08 |
| 1275147381 | Evan Shovels | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-09-04 |
| 1881207744 | Kendra Rose Coburn | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-08-28 |
| 1881207108 | Sarah A Schulte | Technician | 1490 E Beltline Ave Se, Grand Rapids, MI 49506-4336 | 2020-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954705 | Mckenna Shank | Technician | 1409 E Beltline Ave Se, Grand Rapids, MI 49506 | 2020-08-26 |
| 1750917969 | Meghan Elizabeth Southwell | Social Worker | Counseling Center of West Michigan, 360 East Beltline Ave Ne Suite 100, Grand Rapids, MI 49506 | 2020-03-19 |
| 1356876536 | Lisa Finkbeiner | Chiropractor | 1324 Lake Dr Se Ste 1, Grand Rapids, MI 49506 | 2017-04-26 |
| 1447622964 | Ashley Robinson | Rehabilitation Practitioner | 1490 East Beltline Ave, Grand Rapids, MI 49506 | 2015-10-23 |
| 1770951584 | Stuart Segal | Behavioral Analyst | 1415 Wealthy St Se Apt 312, Grand Rapids, MI 49506 | 2015-09-10 |
| 1922476373 | Elizabeth Taylor | Nurse Practitioner | 2255 Wealthy Dr., Grand Rapids, MI 49506 | 2015-09-02 |
| 1780066092 | Carole Walters Counseling | Social Worker | 959 Wealthy St. Se, Grand Rapids, MI 49506 | 2015-06-23 |
| 1053792697 | Rosemary F. Trimpe | Social Worker | 4255 Kalamazoo Se, Grand Rapids, MI 49506 | 2015-06-09 |
| 1164809919 | Gary James | Rehabilitation Practitioner | 1490 E. Beltline Se, Grand Rapids, MI 49506 | 2015-04-30 |
| 1275925315 | Paul Cole | Counselor | 1101 Ball Ave. .se., Grand Rapids, MI 49506 | 2015-02-26 |
| Find all providers in zip 49506 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295227692 | Angel May | Specialist/Technologist, Other | 3905 Brenton Ct Se, Grand Rapids, MI 49508-8948 | 2018-05-31 |
| 1366590499 | Mary Lou Hanks | Specialist/Technologist, Other | 319 Sheldon Blvd Se, Grand Rapids, MI 49503-4515 | 2007-01-08 |
| 1609317932 | Jamin Gentry | Specialist/Technologist, Other | 775 36th St Se, Grand Rapids, MI 49548-2319 | 2017-03-20 |
| 1841684339 | Ann Savino | Specialist/Technologist, Other | 1101 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2015-03-24 |
| 1396137279 | Kimberly Rose | Specialist/Technologist, Other | 1101 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2015-03-02 |
| 1184016404 | Carla Burgos De La Paz | Specialist/Technologist, Other | 1101 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2015-02-24 |
| 1841541307 | Spectrum Health Sleep Disorders Center | Specialist/Technologist, Other | 4100 Lake Dr Se, Suite 100, Grand Rapids, MI 49546-8292 | 2012-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922598515 | Jubin Joseph Cheruvelil | Specialist/Technologist, Other | 446 W. Circle Dr. Room 249 Annex, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824 | 2018-05-18 |
| 1326599937 | Joel Bergwerff | Specialist/Technologist, Other | 2345 Riley St, Hudsonville, MI 49426-9678 | 2016-10-18 |
| 1093264715 | Brittany Adams | Specialist/Technologist, Other | 39749 Fox Valley Dr, Canton, MI 48188-1532 | 2016-09-22 |
| 1790238277 | Lana Ann Colwell | Specialist/Technologist, Other | 102 Arlene Ct, White Lake, MI 48386-1901 | 2016-08-01 |
| 1427400969 | Diane Hines | Specialist/Technologist, Other | 17530 Strathmoor St, Detroit, MI 48235-2725 | 2016-07-08 |
| 1588016331 | Martez Williams | Specialist/Technologist, Other | 3631 Wayburn St, Detroit, MI 48224-3370 | 2016-07-05 |
| 1366893182 | Morgan Kaylee Gadowski | Specialist/Technologist, Other | 197 Lynn Ct, Imlay City, MI 48444-1240 | 2016-06-22 |
| 1124478318 | Katharine Elisabeth Seal | Specialist/Technologist, Other | 45211 Helm St, Plymouth, MI 48170-6023 | 2016-06-17 |
| 1700236247 | Tanya Patrick | Specialist/Technologist, Other | 2306 Mountain Ave, Flint, MI 48503-2298 | 2016-06-15 |
| 1760846737 | Greg Mcgillvary | Specialist/Technologist, Other | Rose Center 100 Central Michigan University, Mount Pleasant, MI 48859-0001 | 2016-04-06 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49506 |
Please comment or provide details below to improve the information on AUDREY JAGT.
| 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.