Individual provider Active NPI

Elisia Jean Grewe, FNP-BC

  • Family Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1679978431
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704259990 Issued in MI
Practice address
117 W Paterson St
Kalamazoo, MI 49007-2557
Phone
(269) 349-2641
NPI assigned
Oct 22, 2014
Last updated
Dec 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704259990 MI Primary

Addresses

Primary practice location

117 W Paterson St
Kalamazoo, MI 49007-2557

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Other practice location 1

1308 N Burdick St
Kalamazoo, MI 49007-2503
Phone (269) 349-2641

Other practice location 2

505 E Alcott St
Kalamazoo, MI 49001-6144
Phone (269) 349-2641

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150327000858 MI Practitioner - Nurse Practitioner 9739406927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Center, Inc.Group PAC ID 1759370216, 51 clinicians

Practice addresses (Care Compare)

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Center Inc CurrentSince Jul 7, 2015 Accepting new patients
Kalamazoo TC Operator LLC CurrentSince Mar 3, 2025 Accepting new patients
Family Health Center Inc. CurrentSince Jul 7, 2015 Accepting new patients
Family Health Center Inc Current Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

117 W Paterson St
Kalamazoo, MI 49007

1308 N Burdick St
Kalamazoo, MI 49007
Phone (269) 488-0803

1430 Alamo Ave
Kalamazoo, MI 49006
Phone (269) 349-2661

505 E Alcott St
Kalamazoo, MI 49001
Phone 2693492641 ext. 715

572 S Odessa Ave
Egg Harbor City, NJ 08215

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1679978431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1308 N Burdick St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490072503",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 E Alcott St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490016144",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREWE",
        "first_name": "ELISIA",
        "middle_name": "JEAN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704259990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.