KELLY R NIEZURAWSKI (NPI# 1992339311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992339311 |
| Entity Type | Individual |
| Full Name | KELLY R NIEZURAWSKI |
| Credential | NP |
| Practice Address |
6500 N Hawkins Hwy Manitou Beach MI 49253-9736 |
| Mailing Address |
Po Box 175 Manitou Beach MI 49253-0175 |
| Practice Telephone | 7345725777 |
| Mailing Telephone | 5174033771 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | 4704187362 | MI | Agencies |
| Street Address |
6500 N HAWKINS HWY |
| City | MANITOU BEACH |
| State | MI |
| Zip Code | 49253-9736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962932236 | Bailey Feekings | Specialist/Technologist | 210 Manitou Rd, Manitou Beach, MI 49253 | 2017-06-19 |
| 1780828699 | Shirley Jo Wilson | Counselor | 765 Manitou Road, Lakeview Counseling Center, Manitou Beach, MI 49253 | 2009-04-22 |
| 1407289374 | Lakeview Family Counseling Center LLC | Counselor | 765 Manitou Road, Manitou Beach, MI 49253 | 2013-08-15 |
| 1588039952 | Christina Jones | Licensed Practical Nurse | 185 S Lakeview Blvd, Manitou Beach, MI 49253-9117 | 2015-12-09 |
| 1578012225 | Robert Clark | Technician, Other | 5075 Belmere Dr, Manitou Beach, MI 49253-9626 | 2016-09-22 |
| 1043832801 | Ksk Medical Pllc | General Practice | 6300 Winter Rd, Manitou Beach, MI 49253-9634 | 2020-05-14 |
| 1801284609 | Barbra Stubli | Licensed Practical Nurse | 3155 Townley Hwy, Manitou Beach, MI 49253-9724 | 2014-12-31 |
| 1225428428 | Kristina Powell | Licensed Practical Nurse | 18733 Slee Rd, Manitou Beach, MI 49253-9741 | 2015-01-27 |
| 1518262393 | Aileen Marie Myers Maloney | Registered Nurse | 6509 Weber Dr, Manitou Beach, MI 49253-9749 | 2011-01-25 |
| 1710348404 | Tonya R Snyr | Registered Nurse | 8388 Round Lake Hwy, Manitou Beach, MI 49253-9779 | 2016-03-09 |
| Find all providers in zip 49253 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881253540 | Sears Transportaion, LLC | PACE Provider Organization | 17800 Northland Park Ct Ste 104b2, Southfield, MI 48075-4304 | 2019-06-06 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1528549300 | Sonja Hunter | PACE Provider Organization | 14459 Greenview Rd, Detroit, MI 48223-2913 | 2018-08-28 |
| 1639687213 | Eastern Grouphome | PACE Provider Organization | 5770 Eastern Ave Se, Grand Rapids, MI 49508-6281 | 2018-01-17 |
| 1578845095 | Comforter Care Agency | PACE Provider Organization | 4830 Malpaso, Lansing, MI 48917-1554 | 2011-09-10 |
| 1427282136 | Jcb Adult Day Services | PACE Provider Organization | 21500 Greenfield Rd, Suite 201, Oak Park, MI 48237-3009 | 2009-05-08 |
| 1598964926 | Finner-williams & Associates | PACE Provider Organization | 17620 W Mcnichols Rd, Detroit, MI 48235-3327 | 2007-07-16 |
| 1043422660 | Progressive Lifestyles, Inc. | PACE Provider Organization | 2669 Potter Rd, Wixom, MI 48393-1832 | 2007-05-04 |
| 1639244734 | Clean House, Inc. | PACE Provider Organization | 24750 Swanson Rd, Southfield, MI 48034-5320 | 2006-11-22 |
| 1952918237 | Pace Central Michigan | PACE Provider Organization | 1750 E Bellows St, Mt Pleasant, MI 48858-3872 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | MANITOU BEACH |
| Zip Code | 49253 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.