Active NPI
Lynn Makela Grund, MD
- Emergency Medicine Physician
- Escanaba, MI
National Provider Identifier
1003820200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 4301079343
- Practice address
- 3401 Ludington St
Escanaba, MI 49829 - Phone
- (906) 786-3311
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4301079343 | MI | Primary |
Addresses
Primary practice location
3401 Ludington St
Escanaba, MI 49829
Mailing address
3650 E Mills Rd
Pickford, MI 49774-9231
Phone (480) 380-6950
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003820200 | Medicaid | MI | |
| LG079343 | Other | MI | BLUE SHIELD |
| 930117023 | Other | MEDICARE - MULT - RAILROAD | |
| 4387722 | Medicaid | MI | |
| P00365745 | Other | MEDICARE - MULT - RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Team Physicians of Arizona PC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Mesa, AZ
- NPI 1710915764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1003820200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3650 E MILLS RD",
"city": "PICKFORD",
"state": "MI",
"postal_code": "497749231",
"telephone_number": "480-380-6950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 LUDINGTON ST",
"city": "ESCANABA",
"state": "MI",
"postal_code": "49829",
"telephone_number": "906-786-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUND",
"first_name": "LYNN",
"middle_name": "MAKELA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "4301079343",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003820200",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "LG079343",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE - MULT - RAILROAD",
"identifier": "930117023",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4387722",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE - MULT - RAILROAD",
"identifier": "P00365745",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Escanaba, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.