Pine Rest Christian Mental Health Services
NPI 1598138810ActiveOrganization· Physician Assistant· Grand Rapids, MI
Physician Assistant in Grand Rapids, Michigan, registered in NPPES in November 2015. The authorized official on file is Diane Fennema, Managed Care Administator.
Overview
| NPI | 1598138810 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 9, 2015 |
| Last updated in NPPES | Nov 4, 2020 |
| Certified by provider | Nov 4, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | MI |
| Counselor, Professional | 101YP2500X | — | MI |
| Psychologist | 103T00000X | — | MI |
| Social Worker | 104100000X | — | MI |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | — | MI |
| Nurse Practitioner | 363L00000X | — | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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