Individual provider Active NPI

Allen Conrad Gruenke, BA

  • Social Worker
  • Lincoln Park, MI
National Provider Identifier
1730381146
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
26184 Outer Dr
Lincoln Park, MI 48146-2084
Phone
(313) 389-7527
Fax
(313) 382-7906
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

26184 Outer Dr
Lincoln Park, MI 48146-2084

Mailing address

9009 Carter Ave
Allen Park, MI 48101-1582
Phone (313) 389-7527

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
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730381146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 CARTER AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011582",
            "telephone_number": "313-389-7527",
            "fax_number": "313-382-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26184 OUTER DR",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462084",
            "telephone_number": "313-389-7527",
            "fax_number": "313-382-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUENKE",
        "first_name": "ALLEN",
        "middle_name": "CONRAD",
        "name_prefix": "Mr.",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.