Active NPI
Emily Magnussen, NP
- Family Nurse Practitioner
- Wyoming, MI
National Provider Identifier
1467917526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704293323
- Practice address
- 5900 Byron Center Ave SW
Wyoming, MI 49519-9606 - Phone
- (616) 252-7200
- NPI assigned
- Feb 4, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704293323 | MI | Primary |
Addresses
Primary practice location
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Mailing address
2433 Raymond Ave SE
Grand Rapids, MI 49507-3923
Phone (616) 915-1331
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250723002237 | MI | Order and Referring Only - Nurse Practitioner | 4688913569 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735603200000",
"number": "1467917526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2433 RAYMOND AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495073923",
"telephone_number": "616-915-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BYRON CENTER AVE SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495199606",
"telephone_number": "616-252-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNUSSEN",
"first_name": "EMILY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-04",
"last_updated": "2024-12-31",
"certification_date": "2024-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704293323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.