Individual provider Active NPI

Grant Oosse

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1396311510
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704342731 Issued in MI
Practice address
770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602
Phone
(616) 272-3533
Fax
(616) 259-4839
NPI assigned
May 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704342731 MI
Family Nurse Practitioner 363LF0000X 3017125 KY
Family Nurse Practitioner 363LF0000X 4704342731 MI Primary

Addresses

Primary practice location

770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602

Mailing address

801 Rosehill Rd
Jackson, MI 49202-1762
Phone (517) 212-2008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704342731MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careline Hmi300 LLC CurrentSince Jun 25, 2024 Accepting new patients

Locations

770 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 272-3533

801 Rosehill Rd
Jackson, MI 49202
Phone (517) 212-2008

Organizations & group practices 1

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1396311510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ROSEHILL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021762",
            "telephone_number": "517-212-2008",
            "fax_number": "517-212-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468602",
            "telephone_number": "616-272-3533",
            "fax_number": "616-259-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OOSSE",
        "first_name": "GRANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-28",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704342731",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017125",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704342731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.