Active NPI
Jennifer L Grzegorek, PHD
- Psychologist
- East Lansing, MI
National Provider Identifier
1063437044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301012797
- Practice address
- 4572S Hagadorn Rd 2E
East Lansing, MI 48823-5385 - Phone
- (517) 896-4231
- NPI assigned
- Jul 12, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301012797 | MI | Primary |
Addresses
Primary practice location
4572S Hagadorn Rd 2E
East Lansing, MI 48823-5385
Mailing address
4572S Hagadorn Rd 2E
East Lansing, MI 48823-5385
Phone (517) 896-4231
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680C31308 | Other | MI | BLUE CROSS & BLUE SHIELD |
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 Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447200000000",
"number": "1063437044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4572S HAGADORN RD 2E",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488235385",
"telephone_number": "517-896-4231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4572S HAGADORN RD 2E",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488235385",
"telephone_number": "517-896-4231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRZEGOREK",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2015-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301012797",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "680C31308",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.