Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amy Gauck Russo, FNP

Individual provider Family Nurse Practitioner · NPI 1316619901

Amy Gauck Russo, FNP is a Nurse Practitioner in Grand Rapids, Michigan. Qualified in 2021, 5 years ago. Practices with Internal Medicine and Pediatrics of West Michigan LLC, an 8-clinician group and accepts Medicare assignment. Licensed in Michigan and Texas.

Years since qualifying
5
Licensed in
MI, TX
In the registry since
2021
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

655 Kenmoor Ave SE Ste 200
Grand Rapids, MI 49546-8622
Phone: (616) 363-7690
Fax: (616) 942-8917
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704302008 (MI)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 1052618 (TX)

Record details

NPI number1316619901
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedOctober 1, 2021
Last updated in NPPESJuly 24, 2025
Certification dateJuly 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Internal Medicine And Pediatrics Of West Michigan Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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