MR. GRANT CONNOR GOODFELLOW D.O.
NPI 1659029205
Student in an Organized Health Care Education/Training Program in Warren, MI

Q: What is Grant Goodfellow's NPI number?

The NPI number for Grant Goodfellow is 1659029205. It was assigned to this individual provider in the NPPES registry on March 14, 2022.

Q: What is Grant Goodfellow's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Grant Goodfellow was last updated on March 28, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 14, 2022PECOS Enrolled

30117 SCHOENHERR RD STE 400, WARREN, MI 48088(586) 738-9470 Get Directions Write a Review

NPPES record last updated: March 28, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Grant Connor Goodfellow D.o. NPPES

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

MR. GRANT CONNOR GOODFELLOW D.O. (NPI 1659029205) is an individual student in an organized health care education/training program in Warren, Michigan and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659029205

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. GRANT CONNOR GOODFELLOWCredential: D.O.

Location Address30117 SCHOENHERR RD STE 400Warren, MI 48088-6854

Mailing Address30117 Schoenherr Rd Ste 400Warren, MI 48088-6854 · (586) 738-9470

Phone(586) 738-9470

Sole ProprietorYes

Enumeration DateMarch 14, 2022

Last NPPES UpdateMarch 28, 2024

NPPES CertifiedMarch 28, 2024

✔ NPI 1659029205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

30117 SCHOENHERR RD STE 400, Warren, MI 48088

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Grant Connor Goodfellow D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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