Individual provider Active NPI

Patricia K. Rau, MSN, CGRN, ANP

  • Adult Health Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1225035843
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704141476 Issued in MI
Practice address
310 Lafayette Ave SE
Suite 400
Grand Rapids, MI 49503-4693
Phone
(616) 752-6525
Fax
(616) 752-6556
NPI assigned
Jun 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Registered Nurse 163WG0100X 4704141476 MI
Adult Health Nurse Practitioner 363LA2200X 4704141476 MI Primary

Addresses

Primary practice location

310 Lafayette Ave SE
Suite 400
Grand Rapids, MI 49503-4693

Mailing address

310 Lafayette Ave SE
Suite 400
Grand Rapids, MI 49503-4693
Phone (616) 752-6525

Other identifiers 1

IdentifierTypeStateIssuer
4385281MedicaidMI

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
Master of Science - Nursing, Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1225035843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE",
            "address_2": "SUITE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-752-6525",
            "fax_number": "616-752-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE",
            "address_2": "SUITE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-752-6525",
            "fax_number": "616-752-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAU",
        "first_name": "PATRICIA",
        "middle_name": "K.",
        "credential": "MSN, CGRN, ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-29",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "MI",
            "license": "4704141476",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704141476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4385281",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.