Individual provider Active NPI

Liberty Anne Clouse, MSN, APRN, FNP

  • Family Nurse Practitioner
  • Norton Shores, MI
National Provider Identifier
1962068544
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704223230 Issued in MI
Practice address
6401 Prairie St
Norton Shores, MI 49444-7840
Phone
(231) 724-7800
NPI assigned
May 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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 4704223230 MI Primary

Addresses

Primary practice location

6401 Prairie St
Norton Shores, MI 49444-7840

Mailing address

15055 155TH Ave
Grand Haven, MI 49417-9511
Phone (616) 204-1118

Other names 1

  • Liberty Anne Abraham 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
I20190729000226 MI Practitioner - Nurse Practitioner 9537495650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privamd Physicians PLLCGroup PAC ID 2466881990, 2 clinicians

Practice addresses (Care Compare)

16986 Robbins Rd
Suite 180
Grand Haven, MI 49417-2795
Phone (616) 213-0253

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704223230MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners CurrentSince Dec 1, 2022 Accepting new patients
Mercy Health Partners CurrentSince Dec 1, 2022 Accepting new patients
Privamd Physicians PLLC CurrentSince Aug 15, 2022 Accepting new patients

Locations

16986 Robbins Rd
Ste 180
Grand Haven, MI 49417
Phone (616) 213-0253

3102 Glade St
Muskegon Hts, MI 49444
Phone (231) 830-1200

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

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

905 E Colby St
Whitehall, MI 49461
Phone (231) 672-8050

Interoperability endpoints

  • Direct secure messaging: liberty.abraham.1@23814.direct.athenahealth.com
  • Direct secure messaging: labraham191210@direct.trinity-health.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1558224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1962068544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15055 155TH AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179511",
            "telephone_number": "616-204-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 PRAIRIE ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494447840",
            "telephone_number": "231-724-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUSE",
        "first_name": "LIBERTY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-19",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704223230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIBERTY",
            "last_name": "ABRAHAM",
            "middle_name": "ANNE",
            "credential": "MSN, APRN, FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.