Active NPI
Jessica Lynn Graczyk
- Social Worker
- Midland, MI
National Provider Identifier
1013560820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802090566
- Practice address
- 4401 Campus Ridge Dr
Midland, MI 48640-6112 - Phone
- (989) 837-9250
- NPI assigned
- Jul 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802090566 | MI | Primary |
Addresses
Primary practice location
4401 Campus Ridge Dr
Midland, MI 48640-6112
Mailing address
4000 Wellness Dr
Midland, MI 48670-2000
Other practice location 1
218 Fast Ice Dr
Midland, MI 48642-6167
Phone (989) 493-5116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4000 Wellness Dr
Midland, MI 48670-2000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802090566 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746403200000",
"number": "1013560820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 WELLNESS DR",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486702000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 CAMPUS RIDGE DR",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406112",
"telephone_number": "989-837-9250"
}
],
"practiceLocations": [
{
"address_1": "218 Fast Ice Dr",
"address_purpose": "LOCATION",
"city": "Midland",
"state": "MI",
"postal_code": "486426167",
"country_code": "US",
"telephone_number": "989-493-5116",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRACZYK",
"first_name": "JESSICA",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-20",
"last_updated": "2025-05-05",
"certification_date": "2025-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802090566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.