Individual provider Active NPI

Michelle Gronowski

  • Registered Nurse
  • Macomb, MI
National Provider Identifier
1174969000
Registry record updated May 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704280063 Issued in MI
Practice address
48515 Stoneacre Dr
Macomb, MI 48044-1883
Phone
(586) 431-0418
NPI assigned
May 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704280063 MI Primary

Addresses

Primary practice location

48515 Stoneacre Dr
Macomb, MI 48044-1883

Mailing address

48515 Stoneacre Dr
Macomb, MI 48044-1883

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704280063MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1368921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368921600000",
    "number": "1174969000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48515 STONEACRE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48515 STONEACRE DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441883",
            "telephone_number": "586-431-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONOWSKI",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-19",
        "last_updated": "2013-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704280063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2013; 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.