Individual provider Active NPI

Kaycie Grusnick, FNP-C

  • Family Nurse Practitioner
  • Lake Orion, MI
National Provider Identifier
1902209802
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704260357 Issued in MI
Practice address
1428 S Lapeer Rd
Lake Orion, MI 48360-1437
Phone
(248) 693-0543
Fax
(248) 630-4301
NPI assigned
Oct 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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 4704260357 MI Primary

Addresses

Primary practice location

1428 S Lapeer Rd
Lake Orion, MI 48360-1437

Mailing address

PO Box 2137
Birmingham, MI 48012-2137
Phone (248) 693-0543

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
I20150408002667 MI Order and Referring Only - Nurse Practitioner 8123346814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Healthcare Associates of Oakland PLLC PastSince Nov 1, 2010 Accepting new patients
Henry Ford Macomb Hospital Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kaycie.grusnick.1@8250.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1902209802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2137",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480122137",
            "telephone_number": "248-693-0543",
            "fax_number": "248-630-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 S LAPEER RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601437",
            "telephone_number": "248-693-0543",
            "fax_number": "248-630-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSNICK",
        "first_name": "KAYCIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704260357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Orion, MI

Sources for this page

Verify at the official NPI Registry.