Individual provider Active NPI

Carly Ann Gilbert, FNP-C

  • Family Nurse Practitioner
  • West Olive, MI
National Provider Identifier
1811629058
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704320746 Issued in MI
Practice address
15151 Stanton St
West Olive, MI 49460-8543
Phone
(616) 685-1950
NPI assigned
Jun 27, 2022
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 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 4704320746 MI Primary

Addresses

Primary practice location

15151 Stanton St
West Olive, MI 49460-8543

Mailing address

5077 Melmax St
Norton Shores, MI 49441-5839
Phone (231) 720-8720

Other names 1

  • Carly Ann Hoekenga Former name

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
I20220901002601 MI Practitioner - Nurse Practitioner 1254715782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Michigan State University College of Human Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Physician NetworkGroup PAC ID 8921996307, 109 clinicians

Practice addresses (Care Compare)

15151 Stanton St
West Olive, MI 49460-8543
Phone (616) 685-1950

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Network CurrentSince Aug 29, 2022 Accepting new patients
Mercy Physician Network CurrentSince Aug 29, 2022 Accepting new patients

Locations

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

15151 Stanton St
West Olive, MI 49460
Phone (616) 296-1020

Interoperability endpoints

  • Direct secure messaging: cgilbert30182@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1811629058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5077 MELMAX ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494415839",
            "telephone_number": "231-720-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15151 STANTON ST",
            "city": "WEST OLIVE",
            "state": "MI",
            "postal_code": "494608543",
            "telephone_number": "616-685-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "CARLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704320746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "HOEKENGA",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Olive, MI

Sources for this page

Verify at the official NPI Registry.