Active NPI
Julie Krauth, NP
- Adult Health Nurse Practitioner
- Traverse City, MI
National Provider Identifier
1164085007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 4704273600
- Practice address
- 4020 Copper VW Ste 104
Traverse City, MI 49684-7041 - Phone
- (231) 421-6921
- NPI assigned
- Apr 16, 2019
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 4704273600 | MI | Primary |
Addresses
Primary practice location
4020 Copper VW Ste 104
Traverse City, MI 49684-7041
Mailing address
3785 Bay Rd
Saginaw, MI 48603-2433
Phone (989) 791-2455
Other practice location 1
2635 Rolling Ridge Rd NW
Rapid City, MI 49676-9117
Phone (231) 564-2126
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | CCM@CHRONIC-CARE.NET | Direct |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704273600 | MI | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604275200000",
"number": "1164085007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3785 BAY RD",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486032433",
"telephone_number": "989-791-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 COPPER VW STE 104",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847041",
"telephone_number": "231-421-6921"
}
],
"practiceLocations": [
{
"address_1": "2635 Rolling Ridge Rd NW",
"address_purpose": "LOCATION",
"city": "Rapid City",
"state": "MI",
"postal_code": "496769117",
"country_code": "US",
"telephone_number": "231-564-2126",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KRAUTH",
"first_name": "JULIE",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-16",
"last_updated": "2020-11-02",
"certification_date": "2020-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MI",
"license": "4704273600",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "CCM@CHRONIC-CARE.NET",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "4020 Copper Vw Ste 104",
"city": "Traverse City",
"state": "MI",
"country_code": "US",
"postal_code": "496847041",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.