Individual provider Active NPI

Ann Krcmarik, NP

  • Gerontology Nurse Practitioner
  • Warren, MI
National Provider Identifier
1578940565
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704234969 Issued in MI
Practice address
27101 Schoenherr Rd
Warren, MI 48088-4730
Phone
(586) 758-5800
Fax
(586) 758-7442
NPI assigned
Apr 29, 2015
Last updated
Apr 29, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704234969 MI Primary

Addresses

Primary practice location

27101 Schoenherr Rd
Warren, MI 48088-4730

Mailing address

27101 Schoenherr Rd
Warren, MI 48088-4730
Phone (586) 758-5800

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704234969MIMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1578940565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27101 SCHOENHERR RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480884730",
            "telephone_number": "586-758-5800",
            "fax_number": "586-758-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27101 SCHOENHERR RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480884730",
            "telephone_number": "586-758-5800",
            "fax_number": "586-758-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRCMARIK",
        "first_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704234969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.