Active NPI
Kayla Ann Wilson-Groves, CTRS
- Specialist
- Clinton Township, MI
National Provider Identifier
1255696506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 59854
- Practice address
- 18248 Fleur de Lis
Clinton Township, MI 48038-1286 - Phone
- (734) 735-1332
- NPI assigned
- Jul 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 59854 | MI | Primary |
Addresses
Primary practice location
18248 Fleur de Lis
Clinton Township, MI 48038-1286
Mailing address
18248 Fleur de Lis
Clinton Township, MI 48038-1286
Phone (734) 735-1332
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
| License | State | Type | Specialty |
|---|---|---|---|
| 59854 | MI | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341964800000",
"number": "1255696506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18248 FLEUR DE LIS",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480381286",
"telephone_number": "734-735-1332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18248 FLEUR DE LIS",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480381286",
"telephone_number": "734-735-1332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON-GROVES",
"first_name": "KAYLA",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "CTRS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-11",
"last_updated": "2012-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "59854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.