MR. CONNOR KENNETH GWINN
NPI 1952058125
Student in an Organized Health Care Education/Training Program in Grand Rapids, MI

Q: What is Connor Gwinn's NPI number?

The NPI number for Connor Gwinn is 1952058125. It was assigned to this individual provider in the NPPES registry on March 7, 2022.

Q: What is Connor Gwinn'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 Connor Gwinn was last updated on March 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 07, 2022PECOS Enrolled

15 MICHIGAN ST NE, GRAND RAPIDS, MI 49503(616) 233-1678 Get Directions Write a Review

NPPES record last updated: March 7, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Connor Kenneth Gwinn NPPES

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

MR. CONNOR KENNETH GWINN (NPI 1952058125) is an individual student in an organized health care education/training program in Grand Rapids, Michigan and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1952058125

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. CONNOR KENNETH GWINN

Location Address15 MICHIGAN ST NEGrand Rapids, MI 49503-2509

Mailing Address225 Hastings St Ne Apt 309Grand Rapids, MI 49503-1526 · (586) 907-1316

Phone(616) 233-1678

Sole ProprietorNo

Enumeration DateMarch 7, 2022

NPPES CertifiedMarch 7, 2022

✔ NPI 1952058125 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.

15 MICHIGAN ST NE, Grand Rapids, MI 49503

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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. Connor Kenneth Gwinn 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICHOLAS WILLIAM NICOLETTI

Student in an Organized Health Care Education/Training Program