Lauren Koenig, NP
Individual provider Active NPI Nurse Practitioner · New Haven, MI
NPI 1003569310 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1003569310
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704314525 (MI)
- Practice address
- 58144 Gratiot Ave
New Haven, MI 48048 - Phone
- (586) 749-5197
- Fax
- (586) 749-5560
- NPI assigned
- Jan 27, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Downriver Community Services Inc
Practice addresses (Care Compare)
58144 Gratiot Ave
Community First Health Centers
New Haven, MI 4804827ND
Phone (586) 749-5197
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220707000253 | MI | Practitioner - Nurse Practitioner | 1355721424 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704314525 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Downriver Community Services, Inc. | Current | Accepting new patients | |
| Downriver Community Services, Inc. | Current | Accepting new patients | |
| Downriver Community Services, Inc. | Current |
Accepting new patients | |
| Detroit Health Care for the Homeless | Past | Accepting new patients |
Locations
555 Saint Clair River Dr
Algonac, MI 48001
Phone (810) 794-4917
1011 Military St
Port Huron, MI 48060
Phone (810) 488-8000
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FHDBCA/Endpoint/FHDBCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704314525 | MI | Yes |
Addresses
Primary practice location
58144 Gratiot Ave
New Haven, MI 48048
Mailing address
4236 Cumberland Rd
Berkley, MI 48072-1677
Other providers in New Haven, MI
- Aline Kalayjian
- Candace Kasper
- Cynthia Kendziuk
- Brandon Sam Khaddor
- Robbon Kippen
- Chandra Lowe
- Majestic Home Healthcare LLC.
- Stephanie Maldonado-Diaz
- Marcus K Free MD PLLC
- Doreen McComas
All providers in New Haven, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.