NPIMap

Individual provider Active NPI

Erin Kucharek, A-GNP-C

  • Primary Care Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1114522471
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704318176 Issued in MI
Practice address
770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602
Phone
(517) 212-2008
Fax
(517) 212-9023
NPI assigned
Dec 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704318176 MI Primary

Addresses

Primary practice location

770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602

Mailing address

801 Rosehill Rd
Jackson, MI 49202-1762
Phone (517) 212-2008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210111002782 MI Practitioner - Nurse Practitioner 2567875594 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northview Health Specialists, PLLCGroup PAC ID 9638422835, 24 clinicians

Practice addresses (Care Compare)

770 Kenmoor Ave SE
Suite 100
Grand Rapids, MI 49546-8602
Phone (616) 272-3533

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704318176MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd Michigan PC CurrentSince May 9, 2024 Accepting new patients
Northview Health Specialists, PLLC CurrentSince Mar 25, 2024 Accepting new patients
Careline Hmi300 LLC CurrentSince Mar 25, 2024 Accepting new patients
Provider Partners Care Management LP Nurse Practitioner CurrentSince Jan 28, 2026 Accepting new patients
Careline Palliative Care LLC Primary Care CurrentSince Mar 25, 2024 Accepting new patients
Northview Medical House Calls PLC CurrentSince Mar 25, 2024 Accepting new patients
Hospice of Holland, Inc CurrentSince Jan 4, 2021 Accepting new patients
Hospice of Holland, Inc. CurrentSince Jan 4, 2021 Accepting new patients
Premier Heart Associates, Inc PastSince Mar 25, 2024 Accepting new patients
Harpal S Jande MD PC PastSince Jun 15, 2021 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

3200 Greenfield Rd
Ste 300
Dearborn, MI 48120
Phone (313) 318-8208

770 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 272-3533

270 Hoover Blvd
Holland, MI 49423
Phone (616) 396-2972

801 Rosehill Rd
Jackson, MI 49202
Phone (517) 212-2008

4760 Fashion Square Blvd
Ste L1
Saginaw, MI 48604
Phone (989) 282-4003

Organizations & group practices 10

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1114522471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ROSEHILL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021762",
            "telephone_number": "517-212-2008",
            "fax_number": "517-212-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468602",
            "telephone_number": "517-212-2008",
            "fax_number": "517-212-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHAREK",
        "first_name": "ERIN",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704318176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.