Individual provider Active NPI

Traci Ellen Adamczyk

  • Registered Nurse
  • Sterling Heights, MI
National Provider Identifier
1073029690
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704136424 Issued in MI
Practice address
43701 Saint Julian CT
Sterling Heights, MI 48314-1804
Phone
(586) 292-3806
Fax
(586) 726-2472
NPI assigned
Dec 19, 2017
Last updated
Dec 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704136424 MI Primary

Addresses

Primary practice location

43701 Saint Julian CT
Sterling Heights, MI 48314-1804

Mailing address

43701 Saint Julian CT
Sterling Heights, MI 48314-1804
Phone (586) 292-3806

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
4704136424MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Home Care, LLC Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1073029690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43701 SAINT JULIAN CT",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141804",
            "telephone_number": "586-292-3806",
            "fax_number": "586-726-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43701 SAINT JULIAN CT",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141804",
            "telephone_number": "586-292-3806",
            "fax_number": "586-726-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMCZYK",
        "first_name": "TRACI",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704136424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.