Individual provider Active NPI

Emanpreet Kaur

  • Adult Health Nurse Practitioner
  • Grandville, MI
National Provider Identifier
1104693506
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AG08230100 Issued in MI
Practice address
6326 Harmon Green Ave SW
Grandville, MI 49418-9761
Phone
(571) 528-0812
NPI assigned
Dec 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG08230100 MI
Adult Health Nurse Practitioner 363LA2200X AG08230100 MI Primary

Addresses

Primary practice location

6326 Harmon Green Ave SW
Grandville, MI 49418-9761

Mailing address

6326 Harmon Green Ave SW
Grandville, MI 49418-9761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404003280 MI Practitioner - Nurse Practitioner 0547608895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

540 Jenner Dr
Allegan, MI 49010-1517
Phone (269) 673-6617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AG08230100MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allegan County Community Mental Health Services CurrentSince Mar 4, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Apr 8, 2024 Accepting new patients
Allegan County Community Mental Health Services CurrentSince Mar 4, 2024 Accepting new patients

Locations

540 Jenner Dr
Allegan, MI 49010
Phone (269) 673-6617

3285 122nd Ave
Allegan, MI 49010
Phone (269) 673-6617

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1104693506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6326 HARMON GREEN AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494189761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6326 HARMON GREEN AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494189761",
            "telephone_number": "571-528-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "EMANPREET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "AG08230100",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "AG08230100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.