Individual provider Active NPI

Cristiana Gherasim, DNP, FNP-BC

  • Family Nurse Practitioner
  • Pontiac, MI
National Provider Identifier
1043962970
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704340834 Issued in MI
Practice address
1685 Baldwin Ave Ste 400
Pontiac, MI 48340-1242
Phone
(248) 977-3758
NPI assigned
Jan 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 4704340834 MI Primary

Addresses

Primary practice location

1685 Baldwin Ave Ste 400
Pontiac, MI 48340-1242

Mailing address

986 Hidden Valley Dr
Lake Orion, MI 48362-1749

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704340834MIMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1043962970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 HIDDEN VALLEY DR",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 BALDWIN AVE STE 400",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483401242",
            "telephone_number": "248-977-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHERASIM",
        "first_name": "CRISTIANA",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704340834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.