Individual provider Active NPI

Debra A McGrain, PROGRAM DIRECTOR

  • Case Manager/Care Coordinator
  • Kenosha, WI
National Provider Identifier
1679854988
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
6233 39TH Avenue
Kenosha, WI 53142-7015
Phone
(262) 654-1004
Fax
(262) 654-6960
NPI assigned
Aug 31, 2011
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

6233 39TH Avenue
Kenosha, WI 53142-7015

Mailing address

6233 39TH Avenue
Kenosha, WI 53142-7015
Phone (262) 654-1004

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

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1679854988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6233 39TH AVENUE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427015",
            "telephone_number": "262-654-1004",
            "fax_number": "262-654-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6233 39TH AVENUE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427015",
            "telephone_number": "262-654-1004",
            "fax_number": "262-654-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRAIN",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "PROGRAM DIRECTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.