Individual provider Active NPI

Emily Kathleen Moutousis, RN

  • Pediatric Registered Nurse
  • Ann Arbor, MI
National Provider Identifier
1245937689
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
4704307321 Issued in MI
Practice address
400 N Ingalls St
Ann Arbor, MI 48109-2003
Phone
(616) 446-8990
NPI assigned
Feb 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 4704307321 MI Primary
Registered Nurse 163W00000X 4704307321 MI

Addresses

Primary practice location

400 N Ingalls St
Ann Arbor, MI 48109-2003

Mailing address

35625 Elmira St
Livonia, MI 48150-2583
Phone (616) 446-8990

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
4704307321MIMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1245937689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35625 ELMIRA ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502583",
            "telephone_number": "616-446-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N INGALLS ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481092003",
            "telephone_number": "616-446-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTOUSIS",
        "first_name": "EMILY",
        "middle_name": "KATHLEEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-15",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MI",
            "license": "4704307321",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704307321",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; 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.