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GRAND RAPIDS
NPI 1528104643
Community/Behavioral Health in Grand Rapids, MI

Active since January 29, 2007CLIA 23D2250463 · Waiver
901 EASTERN AVE NE, GRAND RAPIDS, MI 49503(616) 224-7617(616) 224-7593 Get Directions Write a Review

NPPES record last updated: October 24, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Grand Rapids NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND RAPIDS (NPI 1528104643) is a healthcare organization registered as a community/behavioral health in Grand Rapids, Michigan and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through January 26, 2028 and lists George John Tyndall, Branch Director, as its authorized official.

NPPES Registry Identity

NPI1528104643
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameBETHANY CHRISTIAN SERVICES INC.
Location Address901 EASTERN AVE NEGrand Rapids, MI 49503-1201
Mailing Address901 Eastern Ave Ne, P.o. Box 294Grand Rapids, MI 49503-1201 · (616) 224-7617 · Fax (616) 224-7593
Phone(616) 224-7617
Fax(616) 224-7593
Organization SubpartNo
Authorized OfficialGeorge John TyndallBranch Director · (616) 224-7617
Enumeration DateJanuary 29, 2007
Last NPPES UpdateOctober 24, 2013
✔ NPI 1528104643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in MI · 410218
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedCase ManagementTaxonomy 251B00000X · License CB410200976 (MI)
Also ListedResidential Treatment Facility, Emotionally Disturbed ChildrenTaxonomy 322D00000X · License 635720364 (MI)
901 EASTERN AVE NE, Grand Rapids, MI 49503
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Other Names 1

Other NameGrand Rapids

Other Identifiers 2

Medicare ID-Type Unspecified0D16266MI · Medicare Group Billing
Medicare ID-Type Unspecified0P19460MI · Psychiatric Group

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grand Rapids is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMichiganEnrollment IDO20040913000022Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Grand Rapids, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Sherri Reinsma, LMSW
Clinical Social Worker
NPI 1346760014
901 EASTERN AVE NE
Grand Rapids, MI 49503
(616) 224-7617
✔ PECOS✔ Accepts Medicare0.1 mi
Kaitlin Vredeveld
Mental Health Counselor
NPI 1154870780
901 EASTERN AVE NE
Grand Rapids, MI 49503
(269) 598-9431
✔ PECOS0.1 mi
Dhanashree Mahesh, MD
Psychiatry
NPI 1912081589
1055 MEDICAL PARK DR SE
Grand Rapids, MI 49546
(616) 942-9610
✔ PECOS✔ Accepts Medicare5.3 mi
Alyssa Noe, LMSW
Clinical Social Worker
NPI 1447668397
11335 JAMES ST
Holland, MI 49424
(616) 396-0623
✔ PECOS24 mi
Stacy Mcneely, MSW, LMSW, ACSW
Clinical Social Worker
NPI 1477614063
36 W 8TH ST SUITE 250
Holland, MI 49423
(616) 805-8341
✔ PECOS✔ Accepts Medicare27 mi
Jill Vander Bent, LMSW
Clinical Social Worker
NPI 1952473928
186 S RIVER AVE SUITE 5
Holland, MI 49423
(616) 260-0993
✔ PECOS27 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2250463

Grand Rapids Fire Department · Grand Rapids, MI
Active · expires Jan 26, 2028
CLIA Number23D2250463
Laboratory TypeFire Dept Ems
Certificate Effective DateJanuary 27, 2026
Certificate Expiration DateJanuary 26, 2028
Laboratory DirectorMark Fankhauser
Laboratory Phone(616) 456-3911
Laboratory LocationGrand Rapids Fire Department38 Lagrave Avenue S E, Grand Rapids, MI 49503
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 23D2049484

Grand Rapids Health Care For Homeless Veterans Ser · Grand Rapids, MI
Expired · Sep 30, 2026
CLIA Number23D2049484
Laboratory TypeCommunity Clinic
Certificate Effective DateNovember 7, 2012
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorPriscilla R. Chamberlain
Laboratory Phone(616) 356-1746
Laboratory LocationGrand Rapids Health Care For Homeless Veterans Ser620 Century, Grand Rapids, MI 49503
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bethany Christian Services Inc.'s NPI number?

The NPI number for Bethany Christian Services Inc. is 1528104643. It was assigned to this organization in the NPPES registry on January 29, 2007. The provider is also known as Grand Rapids.

Where is Bethany Christian Services Inc. located?

Bethany Christian Services Inc. is located at 901 Eastern Ave NE, Grand Rapids, MI 49503. The listed phone number is (616) 224-7617.

What is Bethany Christian Services Inc.'s specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Bethany Christian Services Inc. enrolled in Medicare?

Yes. Bethany Christian Services Inc. is registered in the Medicare PECOS enrollment system.

When is Bethany Christian Services Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Bethany Christian Services Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Bethany Christian Services Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (4), Mental Health Counselor (1) and Psychiatry (1). Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Bethany Christian Services Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2250463) is associated with this NPI, valid through January 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Bethany Christian Services Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Bethany Christian Services Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bethany Christian Services Inc. was last updated on October 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.