CENTER FOR ADOLESCENT AND CHILD NEUROLOGY (NPI# 1942620638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942620638 |
| Entity Type | Organization |
| Organization Name | CENTER FOR ADOLESCENT AND CHILD NEUROLOGY |
| Practice Address |
422 Plymouth Ave Ne Grand Rapids MI 49505-6028 |
| Practice Telephone | 6162940010 |
| Mailing Telephone | 6162940010 |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2015-02-17 |
| Authorized Official Name | DR. OLUFEMI OLUSEUN SOYODE (OWNER) |
| Authorized Official Telephone | 6162940010 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
Allopathic & Osteopathic Physicians |
| Street Address |
422 PLYMOUTH AVE NE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49505-6028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184735698 | Olufemi O Soyode | Psychiatry & Neurology | 422 Plymouth Ave Ne, Grand Rapids, MI 49505-6028 | 2006-08-31 |
| 1972626208 | Dean T Smith Md Pllc | Surgery | 422 Plymouth Ave Ne, Grand Rapids, MI 49505-6028 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285276097 | Molly Beth Kerkstra | Home Health Aide | 1115 Ball Ave Nw, Grand Rapids, MI 49505 | 2019-10-14 |
| 1154849677 | Roshawn Nichol Whitley | Technician | 891 Maryland Ave, Grand Rapids, MI 49505 | 2017-09-05 |
| 1447778923 | Kelly Benzin-brinks | Social Worker | 1965 3 Mile Rd Ne, Grand Rapids, MI 49505 | 2017-09-05 |
| 1033560404 | Taylor Nolan Boyd | Speech-Language Pathologist | 400 Ann St Ne Ste 106a, Grand Rapids, MI 49505 | 2016-06-28 |
| 1023465002 | Calvin Athy | Counselor | 1101 Ballave Ne, Grand Rapids, MI 49505 | 2016-05-19 |
| 1821456682 | Kelly Van Huisen | Counselor | 1115 Ball Avenue Ne, Building B, Grand Rapids, MI 49505 | 2016-02-08 |
| 1780051102 | Mark Squeteri | Social Worker | 1345 Monroe Ave Nw Ste 234, Grand Rapids, MI 49505 | 2015-09-02 |
| 1346637337 | Shelby Fullington | Social Worker | 1011 Ball Ave Ne, Grand Rapids, MI 49505 | 2015-04-17 |
| 1457745325 | Lester Anderson II | Social Worker | 1115 Ball Ave, Grand Rapids, MI 49505 | 2015-03-27 |
| 1730570151 | Nicole Brown | Counselor | 1345 Monroe Ave Nw Ste 204, Grand Rapids, MI 49505 | 2015-02-06 |
| Find all providers in zip 49505 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early 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 |
|---|---|---|---|---|
| 1184735698 | Olufemi O Soyode | Psychiatry & Neurology | 422 Plymouth Ave Ne, Grand Rapids, MI 49505-6028 | 2006-08-31 |
| 1215921432 | Brian Eric Woodruff | Psychiatry & Neurology | 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503-2528 | 2005-09-02 |
| 1164866414 | David Sung-wook Moon | Psychiatry & Neurology | 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503-2528 | 2013-04-17 |
| 1497097588 | Harlori Kaur Bains | Psychiatry & Neurology | 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503-2528 | 2013-03-26 |
| 1679898357 | Jena Marie Krueger | Psychiatry & Neurology | 35 Michigan St Ne, Suite 3003, Grand Rapids, MI 49503-2514 | 2010-04-06 |
| 1518128974 | Seth Philip Devries | Psychiatry & Neurology | 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503 | 2008-06-18 |
| 1942461447 | Anastasia Luniova | Psychiatry & Neurology | 35 Michigan St Ne, Suite 3003, Grand Rapids, MI 49503-2514 | 2008-06-18 |
| 1710165030 | Albert Da-tzu Ho | Psychiatry & Neurology | 245 Cherry St Se, Ste 200, Grand Rapids, MI 49503 | 2008-02-08 |
| 1457444531 | Angel W Hernandez | Psychiatry & Neurology | 35 Michigan St Ne, Suite 3003, Grand Rapids, MI 49503-2514 | 2006-10-02 |
| 1114993474 | Jason Umfleet | Psychiatry & Neurology | 35 Michigan Ne, Suite 3003, Grand Rapids, MI 49503 | 2006-02-27 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49505 |
Please comment or provide details below to improve the information on CENTER FOR ADOLESCENT AND CHILD NEUROLOGY.
| 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.