Individual provider Active NPI

Emily Grout, FNP

  • Nurse Practitioner
  • Marysville, MI
National Provider Identifier
1265058390
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704313203 Issued in MI
Practice address
1985 Gratiot Blvd
Marysville, MI 48040-2215
Phone
(810) 216-1200
Fax
(810) 364-0698
NPI assigned
Jun 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704313203 MI Primary

Addresses

Primary practice location

1985 Gratiot Blvd
Marysville, MI 48040-2215

Mailing address

1985 Gratiot Blvd
Marysville, MI 48040-2215
Phone (810) 216-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200917001450 MI Practitioner - Nurse Practitioner 3072931393 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pro-Health Medical FP CurrentSince Mar 1, 2022 Accepting new patients
Port Huron Physicians Medical Group PC CurrentSince Jun 3, 2022 Accepting new patients
Observation Physicians of Macomb PLLC CurrentSince Aug 15, 2020 Accepting new patients

Locations

4190 24th Ave
Ste 208
Fort Gratiot, MI 48059
Phone (810) 216-4000

3003 S Baldwin Rd
Ste B
Lake Orion, MI 48359
Phone (248) 301-1090

1985 Gratiot Blvd
Marysville, MI 48040
Phone (734) 451-9692

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

1266 Walton Blvd
Rochester Hls, MI 48307
Phone (248) 710-2900

416 Woodland Dr
Sandusky, MI 48471
Phone (248) 238-3666

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1265058390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402215",
            "telephone_number": "810-216-1200",
            "fax_number": "810-364-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402215",
            "telephone_number": "810-216-1200",
            "fax_number": "810-364-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROUT",
        "first_name": "EMILY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2023-03-31",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704313203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, MI

Sources for this page

Verify at the official NPI Registry.