Individual provider Active NPI

Lisa K Kurek, NP

  • Nurse Practitioner
  • Allendale, MI
National Provider Identifier
1134603160
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704202201 Issued in MI
Practice address
10273 Chinook Dr
Allendale, MI 49401-4940
Phone
(616) 308-8909
NPI assigned
Sep 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704202201 MI Primary

Addresses

Primary practice location

10273 Chinook Dr
Allendale, MI 49401-4940

Mailing address

10273 Chinook Dr
Allendale, MI 49401-8038
Phone (616) 308-8909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190220000929 MI Practitioner - Nurse Practitioner 6002154804 Reassigns benefits to 1 organization
I20211223000054 FL Practitioner - Nurse Practitioner 6002154804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radial Health Southeast LLCGroup PAC ID 7113357476, 24 clinicians

Practice addresses (Care Compare)

8383 N Davis Hwy
Pensacola, FL 32514-0321
Phone (850) 494-3212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704202201MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince May 1, 2020 Accepting new patients
Sparrow Carson Hospital CurrentSince May 1, 2020 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients
Radial Health Southeast LLC CurrentSince Jan 10, 2022 Accepting new patients

Locations

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

499 Alternate Keene Rd
Largo, FL 33771
Phone (727) 586-4211

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

6767 86th Ave N
Pinellas Park, FL 33782
Phone (727) 548-5566

8701 49th St N
Pinellas Park, FL 33782
Phone (386) 760-7773

10801 Johnson Blvd
Seminole, FL 33772
Phone (727) 398-0166

1501 Pasadena Ave S
South Pasadena, FL 33707
Phone (727) 341-7777

6500 38th Ave N
St Petersburg, FL 33710
Phone (727) 341-4870

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

521 Atwood Ave N
St Petersburg, FL 33702
Phone (727) 526-7000

255 59th St N
St Petersburg, FL 33710
Phone (727) 302-3752

10300 4th St N
St Petersburg, FL 33716
Phone (727) 568-1000

3152 Little Rd
Trinity, FL 34655
Phone (727) 271-9156

8175 Reliable Pkwy
Chicago, IL 60686

Organizations & group practices 4

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": "1536969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1134603160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10273 CHINOOK DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018038",
            "telephone_number": "616-308-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10273 CHINOOK DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494014940",
            "telephone_number": "616-308-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUREK",
        "first_name": "LISA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-15",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704202201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allendale, MI

Sources for this page

Verify at the official NPI Registry.