Unknown Individual – Psychiatry Physician, NPI 1679515803

Unknown Individual is a healthcare provider. based in Grand rapids, Michigan. specializing in Psychiatry Physician. They hold a License No. 4301031247 (MI). The NPI Number for Unknown Individual is 1679515803

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1679515803
Phone
(616) 455-5000
Address
300 68TH ST SE
Deactivation Date
3 July 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Pine Rest Christian Mental Health Services, 300, 68th Street Southeast, Grand Rapids, Gaines Township, Kent County, Michigan, 49501, United States

    GRAND RAPIDS, MI 495486927

    Phone: (616) 455-5000

    Type: Mailing

  • 1445, Sheldon Road, Grand Haven, Ottawa County, Michigan, 49417, United States

    HARBOR DUNES HEALTH CENTER

    GRAND HAVEN, MI 49417

    Phone: (616) 847-5145

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49548)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1679515803 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Psychiatry Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Grand Rapids?
Unknown Individual currently maps to Grand Rapids, Michigan in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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