Carol Irene Teneyck, NP

Primary specialty

Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X

License

4704119230 Issued in MI

Practice address

230 Michigan St NE
Suite 230
Grand Rapids, MI 49503-2550

Phone

(616) 774-2822

Fax

(616) 391-8665

NPI assigned

Mar 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science - Nursing, Nurse Practitioner

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 and National Provider Directory roles.

• Nephrology Consultants of Grand Rapids PC

  • Nephrology Physician
  • Grand Rapids, MI
  • NPI 1528254877
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1255461687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-774-2822",
            "fax_number": "616-391-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MICHIGAN ST NE",
            "address_2": "SUITE 230",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032550",
            "telephone_number": "616-774-2822",
            "fax_number": "616-391-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENEYCK",
        "first_name": "CAROL",
        "middle_name": "IRENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704119230",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704119230",
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "MI",
            "license": "4704119230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "500D111930 / 876270",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4984741",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Burt Temple
• James Henry Tenbrink, PA
• Josephine Antoinette Tenbrink, DNP, APRN
• Sarah Tenckinck
• Shanna Claire Tenclay, MD
• McKenzie Tenhagen
• Tennyson Mackey Counseling LLC
• Charlene Tennyson, MD
• Maria Tenuta, RN, LLMSW
• Abigail Christine Tepper, OTRL

• Medical-Surgical Clinical Nurse Specialist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Medical-Surgical Clinical Nurse Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.