Individual provider Active NPI

Lesley Gruschow

  • Registered Nurse
  • Churchville, NY
National Provider Identifier
1689060154
Registry record updated Apr 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
22 681355 Issued in NY
Practice address
94 Greenway Blvd
Churchville, NY 14428-9207
Phone
(585) 315-6638
NPI assigned
Apr 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 22 681355 NY Primary

Addresses

Primary practice location

94 Greenway Blvd
Churchville, NY 14428-9207

Mailing address

94 Greenway Blvd
Churchville, NY 14428-9207

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

State licenses

LicenseStateTypeSpecialty
22 681355NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1428796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428796800000",
    "number": "1689060154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 GREENWAY BLVD",
            "city": "CHURCHVILLE",
            "state": "NY",
            "postal_code": "144289207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 GREENWAY BLVD",
            "city": "CHURCHVILLE",
            "state": "NY",
            "postal_code": "144289207",
            "telephone_number": "585-315-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSCHOW",
        "first_name": "LESLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-12",
        "last_updated": "2015-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "22 681355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Churchville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.