Individual provider Active NPI

Mary Grace Crock-Ring, R.N.

  • Registered Nurse
  • South Haven, MI
National Provider Identifier
1992096184
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704180622 Issued in MI
Practice address
1007 East Wells Street
South Haven, MI 49090-9612
Phone
(269) 637-5297
Fax
(269) 637-9238
NPI assigned
Apr 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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 4704180622 MI Primary

Addresses

Primary practice location

1007 East Wells Street
South Haven, MI 49090-9612

Mailing address

P.O. Box 249
801 Hazen Street
Paw Paw, MI 49079-0249
Phone (269) 657-5574

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704180622MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Van Buren Community Mental Health Authority PastSince Jul 1, 1990 Accepting new patients

Organizations & group practices 1

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": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303430400000",
    "number": "1992096184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 249",
            "address_2": "801 HAZEN STREET",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490790249",
            "telephone_number": "269-657-5574",
            "fax_number": "269-657-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 EAST WELLS STREET",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490909612",
            "telephone_number": "269-637-5297",
            "fax_number": "269-637-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCK-RING",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704180622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.