Kelly Raye Salik

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704206999 Issued in MI

Practice address

3097 Prairie St SW
Grandville, MI 49418-2000

Phone

(616) 531-9973

Fax

(616) 531-5577

NPI assigned

Feb 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Treece Home Care Inc

  dba Community Care Givers

  • Home Health Agency
  • Grandville, MI
  • NPI 1649257734
  NPD (past)

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1174155063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8165 DIETZ RD",
            "city": "BELDING",
            "state": "MI",
            "postal_code": "488099408",
            "telephone_number": "616-894-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3097 PRAIRIE ST SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182000",
            "telephone_number": "616-531-9973",
            "fax_number": "616-531-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALIK",
        "first_name": "KELLY",
        "middle_name": "RAYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704206999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4704206999",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Rozema, FNP
• Steven James Runner, TLLP
• RX Optical Laboratories, Inc.
• Sage Creek Counseling LLC
• Byron Otoniel Salguero, MA
• Jacqueline Violeta Sanchez
• Mark Sanders, PSY.D
• Trisha Anne Sanjose, CPHT
• Keesha Reann Santa Maria
• Arielle Saracinello, LMSW

• Registered Nurse in Grandville, MI
• Providers in Grandville, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.

Verify at the official NPI Registry.