Mary Christine Grassl, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

91223 Issued in WI

Practice address

2814 S 108TH St
West Allis, WI 53227-3224

Phone

(414) 885-3525

NPI assigned

Feb 10, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1558068429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 N 90TH ST STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584437",
            "telephone_number": "480-977-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 S 108TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532273224",
            "telephone_number": "414-885-3525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 College Ave Ste M1",
            "address_purpose": "LOCATION",
            "city": "South Milwaukee",
            "state": "WI",
            "postal_code": "531721150",
            "country_code": "US",
            "telephone_number": "414-775-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23 W Scott St",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549352342",
            "country_code": "US",
            "telephone_number": "920-926-0101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRASSL",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "91223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN-91223-30",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in West Allis, WI
• Providers in West Allis, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.